Maternity services in Portlaoise hospital still not under Coombe’s control

A plan to place maternity services at the Midland Regional Hospital in Portlaoise under the control of one of the big Dublin maternity hospitals has yet to be implemented, over a year after the services were found to be unsafe.

An official report early last year recommended the unit be placed under the governance of the Coombe Women's Hospital to provide quality and safe healthcare. The report's author, Department of Health chief medical officer Dr Tony Holohan, said this should take place before the end of June 2014.

The Health Service Executive confirmed yesterday this has not happened and a draft memorandum of understanding (MoU) between the two institutions "is being considered".

Portlaoise is at the centre of a highly charged row this week between the HSE and the Health Information and Quality Authority (Hiqa) over a critical draft report by the authority into the hospital. The HSE has threatened to take legal action to prevent publication of the report, which it says makes over 250 adverse findings against a wide range of people and organisations.

Alternative to closure

Placing the maternity unit in Portlaoise under the governance of the Coombe was seen as a way of dealing with the problems at the unit while avoiding its closure. Dr Holohan’s investigation was prompted by revelations of at least four problematic baby deaths in the unit.

The Coombe, which was not consulted before the plan was announced, balked at taking on the responsibility without extra staff and resources being provided, The Irish Times understands.

The HSE said extensive discussions had taken place with the Coombe and the MoU being considered would contain detail of arrangements providing for a maternity clinical network across the Dublin Midlands Hospitals Group.

Portlaoise exception

The move is unusual in that it will see greater control of part of a HSE hospital, Portlaoise, move to a voluntary hospital, the Coombe. The general trend in health governance in recent times has been in the opposite direction.

Negotiations on the MoU are at an advanced stage and may be finalised in the coming weeks, said one source.

A number of other changes had been made in the wake of Dr Holohan’s report, the HSE has pointed out. These include appointment of a dedicated management team for the maternity service at Portlaoise, a new hospital manager, an extra obstetrician and additional midwifery posts. Extra training has been provided.

The Hiqa report may not be published until next month after it agreed to provide the HSE with additional information in relation to the findings in the draft report. HSE director general Tony O’Brien had claimed the report lacked balance, contained inaccuracies and accused staff of “recklessly endangering” patients.