The Maternity Clinical Complaints Review, published by the Health Service Executive (HSE), is long overdue. That it includes a clear declaration that maternity services at Portlaoise Hospital are now safe and fit for purpose is welcome. And it is important that the HSE has apologised to 14 families, including eight in which a baby died.
The review looked at 153 maternity-related complaints made after an RTÉ programme in January 2014 on baby deaths at Portlaoise. The cases spanned 40 years, most of which related to the maternity unit at Portlaoise. Crucially, it found no evidence of a trend of failing to respond to abnormal CTG tracings – which monitor the baby’s well-being during labour – that might have been a contributory factor in the deaths of babies.
One of the key participants in the review, the patient representative body, Patient Focus, expressed concern that the HSE was unable to conduct a “timely” examination that met the needs of patients and families and as a result it was very difficult for them to feel included and confident that their concerns matter. It noted the process stumbled along until eventually a productive approach was adopted. The lay-out of the report reflects this troubled approach.
The review did not identify any trends in clinical practice among current staff at Portlaoise “which would require referral to disciplinary processes”. But there is no reference to the administrative failings of the HSE outlined by the Health Information and Quality Authority (Hiqa) in a 2015 report on the matter. That highlighted the fact that a series of reports on other hospitals between 2008 and 2013 that should have led to improvements at Portlaoise, were not fully acted on.
Birth outcomes here are among the best in the world. But the 2016 National Maternity Strategy recommends that services should be more woman-centred and that a system of integrated, team-based care must be implemented in full if we are to maintain high standards in obstetric care. Commanding the full confidence of child-bearing women requires nothing less.