National Maternity Hospital and Rotunda stop monthly data on baby deaths

The two biggest Dublin maternity hospitals have stopped publishing monthly figures on baby deaths and serious incidents, just months after the publication of detailed performance information began nationally.

The National Maternity Hospital and the Rotunda have dropped the practice of reporting the number of clinical incidents because, they say, it is not an indicator of safety in their maternity units.

The two hospitals have also stopped publishing monthly details of the number of baby deaths and the major obstetric events, such as seizures, ruptures and hysterectomies, because the number of cases involved is small.

However, they say it is their intention to publish these rates every quarter “as a more informative and accurate reflection of a trend rather than the individual monthly rates previously reported”.

The other Dublin maternity hospital, the Coombe, is expected to follow suit shortly, according to informed sources.

The Department of Health said it "expects each individual maternity hospital will make arrangements to publish a full maternity patient safety statement on their websites".

Information on baby deaths, major obstetric events and clinical incidents continues to be published monthly for the other 16 HSE-run maternity units in the State. The most recently published data, for March, is almost three months out of date.

The publication of detailed information on the performance of maternity units was championed by Department of Health chief medical officer Dr Tony Holohan and stemmed from a recommendation in the Hiqa report into baby deaths at Portlaoise hospital. However, it ran up against resistance from the masters of the Dublin maternity hospitals.

They argued, in correspondence with the HSE last year, that publication of the data would leave hospitals open to adverse publicity and media scrutiny, pose risks to patient confidentiality and encourage inappropriate comparisons between maternity units of varying size and complexity.

Eventually, the system got underway with publication of data for last December. It showed 660 clinical incidents were reported in the maternity units that month, and there were 13 baby deaths and eight major obstetric events.

The three Dublin maternity hospitals initially omitted information on clinical incidents but added it after The Irish Times reported on their statements. This information has now been omitted again from the statements published by the NMH and the Rotunda.

“We do not believe that reflecting the number of clinical incidents reported to the Clinical Indemnity Scheme is any indicator of safety or can usefully be used as such an indicator,” a Rotunda spokeswoman said.” Additionally, there is currently no agreement amongst hospitals nationally as to which events require filing in a clinical incident report.”

The safety statements published by the HSE provide information on 17 different metrics, including the number of babies delivered and the number of transfers to or from a hospital.

The statements do not include information on the number of maternal deaths, or the rate of perinatal death for babies born without a congenital anomaly.

Dr Holohan said last week he was “happy” with the way the hospitals were reporting performance data from maternity units.