Hospital reviews need reform to ensure patients get 'real answers', according to legal expert 

Health minister Jennifer Carroll MacNeill has been briefed on the situation, a spokesman said. Picture: Brian Lawless/PA

Hospital reviews for death or serious injury to newborn babies need to be reformed to ensure parents get real answers, a Cork legal expert has said.

There are widespread concerns around Portiuncula maternity unit in Galway, which is now subject to separate reviews into the care of nine babies over the last two years. They include two cases of still-birth babies in 2023.

These incidents happened despite similar cases being investigated ten years ago and reported on in 2018, as well as eight reviews between 2019 and 2023.

A report issued in 2018 made 154 recommendations, which were implemented, according to the HSE.

Lyndy Cantillon, partner at Cantillons Solicitors in Cork, said she heard of these latest reviews with regret. They centre mainly on babies who developed hypoxic ischemic encephalopathy (HIE), a condition caused by lack of oxygen or blood to the baby’s brain around birth.

“I believe it is not a process that will bear much fruit in terms of assisting the parents to understand what happened and why it happened,” she said.

I say this not to be critical of the hospital itself, but rather I am critical of the HSE, and the approach they maintain in cases involving medical negligence which remains very guarded. 

In her experience the reviews include staff comment and a review of patients’ health records.

“There is usually little to no involvement of the injured party, or in this case, the parent(s) of the baby who without doubt, will have the most vivid account of how events unfolded,” she said.

Parents give, she said, “ a more fulsome and accurate view” and the experience may help them also.

However, she has seen situations where reviews did not involve or even inform bereaved parents. That is not the case in Portiuncula, the HSE has said.

Ms Cantillon called for meaningful involvement of parents to be mandatory.

The hospital has said the incidence of HIE, with the babies sent for neonatal cooling treatment, is significantly higher than expected. Ms Cantillon warned: 

There are plenty of cases I have come across over the years where no such incident reports are filed, and issues do not come to light until the case is investigated by the parents/patients. 

This can mean missed cases, especially if babies do not meet the criteria for HIE on delivery, perhaps because they were born prematurely, she indicated.

“These babies are discharged home to their parents who sadly are not aware that their child suffered a brain injury until much later — when they do not meet their milestones,” she said.

The solicitor said she is not aiming her criticism at individual staff but at the review systems which do not allow for the investigations and resulting learning needed.

Another key issue in maternity units is understaffing, which she said leads to “immense pressure which undoubtedly will allow for mistakes to happen”.

Health minister Jennifer Carroll MacNeill has been briefed on the situation, a spokesman said.

“Once the individual reviews are complete the Minister will consider next steps with her officials and the HSE,” he added.