Time for a new kind of approach - Baby deaths in Cavan

CONFIRMATION that four babies have died in 30 months at the maternity unit at Cavan General Hospital adds to the growing sense of unease around our health services, especially our maternity services. That it comes so very soon after relevations about five baby deaths at Midland Regional Hospital in Portlaoise exacerbates that concern.

That, in the Dáil yesterday, Fianna Fáil leader Micheál Martin referred to internal HSE correspondence that admitted that numerous cases “as sad and as serious” as the Portlaoise deaths scandal have occured at “other sites around the country” begins to push the issue towards the national scandal category. That the HSE seems to have, on a matter of great public concern, wilfully adopted a policy of self-serving stonewalling and denial pushes these issues a good distance across the scandal red line.

That one of our national afflictions — the absence of accountability in vital public services — underpins both of these tragedies suggests that the time has come for a different kind of response. That assertion can be made despite all of the challenging issues around resources, as it seems that human failure was at the root of some of these avoidable deaths and the heartbreak they inflict on families.

Speaking in the Dáil, Mr Martin said an internal HSE email is another sign that the organisation is “attempting to suppress” evidence of serious maternity service problems, and is indicative of the lack of urgency shown by management in implementing reforms. The snail’s-pace response was highlighted in the Hiqa report on Portlaoise.

This refusal to accept the obvious may be one of the reasons claims against the HSE are climbing at such an alarming rate. Earlier this week, we reported the HSE is facing a claims crisis with the number of High Court cases against the body almost doubling to record levels in five years. The State Claims Agency was dealing with more than 3,000 claims at the end of 2013 and anticipated the bill would hit €1bn.

That is not the only cost this reticence forces on the exchequer. This as-we-are hubris has led to suggestions that a national body — and all of the expense that infers — is needed to ensure that patients’ concerns are properly dealt with. This may sound like a positive move but if health managers did their jobs properly, it wouldn’t be necessary.

Suggestions earlier this week that the ratio of safe, uncomplicated births is far higher in private hospitals than it is in pubic hospitals, suggests too that the far greater level of clinical accountability demanded in private hospitals has a decisive and positive influence. This is a cultural rather than a resource issue. As these scandals came to light, the first steps in new negotiations on public sector pay were taken. These scandals prove again that accountability is an alien idea in our public services. New measures that would force managers to accept the consequences of their actions — or inactions — should be put at the top of the agenda. Any new pay deal should be dependent on the acceptance of new legislation that would make it possible to remove poor managers from our public services — remove and not push to one side.

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