HSE ‘failed to enforce Savita reforms’

The head of one of Ireland’s leading maternity hospitals has claimed the HSE has failed to enforce reforms called for in the aftermath of Savita Halappanavar’s death, insisting dangerous services and staff gaps remain.

Master of the Rotunda, Dr Sam Coulter Smith, made the allegations in a clinical report for the facility and before an update report due out later today is set to say local progress has been made at University Hospital Galway.

Writing in the Rotunda report, Dr Coulter Smith said despite the high-profile nature of the tragedy two years ago, “services and staffing levels in the maternity sector” remain at crisis point.

He said “despite representations to the HSE and to the Department of Health, little has been done” to address the issue. “Our midwife-to-patient ratio is too low and we require more consultants to staff our maternity units.

“These issues are compounded by increasing difficulty in attracting sufficient numbers of good junior staff into the speciality,” he wrote.

His comments come as the HSE’s Saolta Hospital Group, which oversees University Hospital Galway, is set to publish the findings of an external review of whether reforms have been implemented since Ms Halappanavar’s tragic death in the hospital.

While Dr Coulter Smith’s remarks focussed on the national situation, the Galway report is understood to state that local improvements are occurring, although it will also acknowledge staff and funding pressures affecting all hospitals are impacting on care.

Meanwhile, the Rotunda report has also confirmed that three women died during pregnancy at the Dublin hospital in 2013, bringing the total number of maternal fatalities there to 13 in five years. Two of the deaths in 2013 related to significant pulmonary embolisms, an issue which can be difficult to diagnose and is among the leading three causes of death during pregnancy in the world.

Dr Coulter Smith said that in part due to existing systems it can be difficult to uncover embolisms before there is a serious risk to the pregnant woman.

He said the hospital is now planning to launch a thrombo-embolism risk assessment in a bid to help detect the risk of this condition, even in expectant mothers who have initially been given the all-clear.