The announcement of a fourth baby death in the space of 30 months at Cavan General Hospital is worrying. Coming on top of the profoundly shocking Health Information and Quality Authority (Hiqa) report into services at the Midlands General Hospital, Portlaoise, the news will contribute to growing public unease about patient safety in our public hospitals. While it must be acknowledged, pending the outcome of the investigation, that the death of the baby shortly after an emergency Caesarean section in Cavan on Monday may not have been preventable, the fact that it occurred in one of the country's smaller maternity units is a concern.
There are 19 maternity units throughout the State. A National Maternity Strategy was first called for following the tragic death of Savita Halappanavar in 2012 but is only now getting under way. We need to know if established difficulties in recruiting permanent hospital consultants are affecting the safe operation of these units. Are smaller maternity units staffed with adequate numbers of experienced midwives to ensure the safe care of mothers and babies? Does each unit have a strong working relationship with the nearest major obstetric unit to facilitate the routine transfer of complicated pregnancies to a larger hospital? Does each unit have state-of-the-art scanning equipment and full paediatric back-up?
The HSE must, as a priority, take the findings of the Portlaoise report and cross-check to see if any of the named deficiencies identified at the Midlands hospital apply in other smaller units. We must also be assured the National Standards for Better Safer Healthcare, which specify the prompt actions to be taken when safety deficits are identified, are being followed nationally. And in the continued absence of individual HSE managers coming forward to acknowledge their role in the failures identified in the Hiqa report, the Minister for Health must, to ensure patient safety, take definitive action to fundamentally change the dysfunctional working culture prevalent in the HSE. Disciplinary action may be the only way to achieve a safer health service for all.