Families at the centre of a review into maternity care at Portiuncula University Hospital have called into question the “ongoing viability” of the service after a review found the way in which it operates “is no longer sustainable”.
A Health Service Executive report published on Wednesday summarised five reviews of care provided to women and their babies at the Co Galway hospital, and found there were “significant clinical risks” at the maternity unit.
It found the issues at the hospital “could plausibly arise in other similar sized maternity units”. Other small maternity hospitals include the ones in South Tipperary, Kerry, Portlaoise, Sligo, Mayo, Kilkenny and Cavan.
Following the publication of the review, expectant mothers who have higher-risk pregnancies will have their antenatal care moved to other maternity units in the area, the HSE announced.
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Ciaran Tansey, a partner at Damien Tansey Solicitors, which represents a number of affected families, said the summary report has raised questions for them about whether the Ballinasloe maternity unit should continue to operate at all.
“The deficiencies in Portiuncula hospital’s maternity service have clearly been there for some time, but they remained either undetected or not adequately acted upon,” he said.
“The families are left with the impression that remedial steps seem to only follow adverse events having occurred at the hospital. But where was the proactivity that was needed, in particular by the newborns and their families?”
Mr Tansey added: “At present the view is that the ongoing viability of Portiuncula hospital’s maternity service has been called into question.”
The expert group that reviewed the Galway hospital said it delivered 1,400 babies annually. It said a unit of such size “cannot provide the full range of maternity and newborn services”.
The expert group said it strongly recommended a review into the way maternity services are delivered across the country.
There were four “common themes of concern”, which are: communication; governance; clinical care, leadership and clinical governance; and infrastructure.
Since January, a total of 12 reviews have been announced into the care given to women and babies at the Ballinasloe hospital following a number of incidences of neonatal encephalopathy (NE) requiring therapeutic hypothermia (known as neonatal cooling) being identified in a short time period.
Five of these reviews have been completed, five are under way and a further two are due to begin.
Speaking in the Dáil on Thursday, Minister for Health Jennifer Carroll MacNeill said the concern about maternity care was “specific to Portiuncula”.
The hospital demonstrated “a much higher than expected rate of requirement for Caesarean sections and cooling of the baby. This was a specific issue,” she said.
The report published on Wednesday comes after a similar document, known as the Walker report, in 2018 found issues of a similar nature.
Since then, the Minister said, there had been a 100 per cent increase in the number of obstetric consultants and a 25 per cent increase in the number of midwives at Portiuncula.
“The report has been implemented, and increased resources were provided yet there is still a problem. We have to respond to that problem from a patient safety perspective. High-risk pregnancies are being moved to Galway,” she said.
According to the HSE, factors that contribute to higher-risk pregnancies include previous loss of a baby, history of significant medical disease, history of massive obstetric haemorrhage, obesity and maternal age.
Women considered likely to deliver their baby before 35 weeks’ pregnancy will also have their care moved from Portiuncula, it said.
The HSE said it was committed to implementing the 34 recommendations contained in the reviews and had established an implementation team.
