HSE to request increased staffing for maternity hospitals

Dr Peter Boylan says HIQA report is an ‘appalling indictment of State failure’

Dr Peter Boylan clinical director of the National Maternity Hospital who said the HIQA report was an appalling indictment of State failures over many years.  Photograph: Brenda Fitzsimons/The  Irish Times

Dr Peter Boylan clinical director of the National Maternity Hospital who said the HIQA report was an appalling indictment of State failures over many years. Photograph: Brenda Fitzsimons/The Irish Times

Thu, Oct 10, 2013, 13:55

The Health Service Executive is to request an increase in staffing for maternity services following the publication of a report which found significant deficiencies in the care of critically ill women in the State’s 19 maternity hospitals.

HSE National Director of Quality and Patient Safety Dr Philip Crowley said this morning that it was recognised “if you have adequate staffing levels in terms of midwives and consultants we can provide a more consultant-led service”.

He said the current maternity service numbers do not allow for that and that a request in relation to increased staffing would be made to the Minister for Health.

He was responding to comments from the clinical director of the National Maternity Hospital who said staffing levels in Irish maternity hospitals were unacceptably low.

The Health Information and Quality Authority report into the death of Savita Halappanavar published yesterday found significant deficiencies in the care of critically ill women in maternity hospitals.

It pointed to 13 “missed opportunities” that, had they been identified and acted upon, could have resulted in a different outcome for Ms Halappanavar, who died in University Hospital Galway last October.

Hiqa identified shortcomings in maternity care generally and has called for a national review of maternity services.

Dr Boylan described the report as an “appalling indictment of State failures over many years” in the provision of a safe maternity service infrastructure, with the lack of staff a key issue.

“If you take the minimum recommended number of consultant obstetricians for the number of births, not including gynaecology, there should be at least 200 in the state, but there’s 120, so we are far behind.”

“In the National Maternity Hospital we have the equivalent of eight consultants, whereas if we were in Denmark or Norway or Sweden, we’d have about 50.”

He also said staffing levels in Irish maternity hospitals are 30 per cent lower than recommended international standards.

Mr Boylan also identified a number of failings in the HIQA report, including that while it identified failings in the care of Ms Halappanavar, it did not state what staff in University Hospital Galway should have done differently in this case.

He also said the law on terminations “undoubtedly inhibited” the medical team in Galway from intervening and delivering Ms Halappanavar when intervention by delivery would have saved her life.

Dr Boylan said this aspect was “deliberately left out of the report” because the question was not asked because it was not in the terms of reference and that this was a “deliberate omission on the part of the HSE which commissioned the report.”

“The State commissioned the report but didn’t ask the obvious question,” he told RTÉ’s Morning Ireland.