HSE head unable to clarify when Portiuncula hospital will resume care for high-risk pregnancies

Last year, five babies were sent for therapeutic hypothermia, known as cooling, which meant the Portiuncula Hospital's rate for this procedure was 'significantly' higher than at other hospitals. File photo

Up to 300 women with high-risk pregnancies still cannot be cared for at Portiuncula hospital and HSE CEO Bernard Gloster apologized but could not say when high-risk care can resume there.

The care needed for 12 women and their babies had to be reviewed. Of those, seven are finished and five are ongoing, the Oireachtas Health Committee heard.

Last year, five babies were sent for therapeutic hypothermia, known as cooling, which meant the hospital’s rate for this procedure was “significantly” higher than at other hospitals, obstetrician Dr Cliona Murphy told the committee.

Also in 2023, analysis of care in two cases of stillborn babies revealed concerns.

Mr Gloster said: “I particularly want to acknowledge the women and their partners whose story has been and remain the subject of these case reviews. To them I apologise on behalf of the health service.” 

He expects all reviews to be finished by March next year. However, as a result Portiuncula stopped booking high-risk pregnancies in October. He could not give a date for when this can resume.

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Reforms are being monitored by HSE West and NorthWest with the National Women and Infants Health Programme (NWIHP).

Women with specific clinical issues, including with a history of unexplained stillbirth, pre-existing illness or a BMI of 40 or over, are seen instead in Galway or Mullingar hospitals. This comes to “between about 250 and 300 women” the committee was told.

When asked by TDs whether those hospitals have received extra supports, the local HSE said they had but did not have specific numbers.

TDs including Dr Martin Daly, who works locally, asked why a previous review, the Walker Report 2018, was not implemented. Regional executive officer Tony Canavan said they tried to carry out a recommendation for joint governance across Galway and Portiuncula hospitals.

“We did appoint a clinical director to fulfil that function, but by agreement on both sides when it wasn’t working, we stood that arrangement down,” he said. There was tense disagreement between speakers and committee as to how this had been supported.

Mr Gloster later told Sinn Féin TD Claire Kerrane: “The Walker report was technically implemented, but as I have said technically is no good if it’s not sustainable. And it clearly was not sustainable.” 

Committee chair Padraig Rice raised growing fears in the region the maternity unit could be closed.

In response Mr Gloster said: 

I can absolutely categorically say to you I have not received one ounce of direction, discussion or hint from the minister, from the department, from the board of the HSE to in any way alter or reconfigure services in the region, including Portiuncula. 

He added: “You would close a unit if it continued to dysfunction and be unsafe. And if it didn’t improve, then you would consider what you do. But I don’t believe that is going to be the case here.” 

The HSE also noted an upcoming review of all maternity units in preparation for a new national maternity strategy. The current strategy expires next year.

Dr Cliona Murphy, clinical director at NWIHP, also told Labour’s Marie Sherlock access to home births shows “regional inequality” generally. She said: “we recognise there are areas like the West that don’t have as wide a spread (of access).” 

Dr Murphy also said suspension of homebirths in the Midwest remains with “findings of a very serious review there” under consideration.