Rotunda master raises concerns over whether report will be acted on

The master of the Rotunda Hospital has said he is concerned about the extent to which the Health and Information and Quality Authority report into the death of Savita Halappanvar will be acted on, given past failures to implement reports’ recommendations.

Referencing a KPMG report on maternity services in 2008, Dr Sam Coulter Smith said: “My concern is that when these sort of reports have come out before not all of the recommendations have been acted upon.

“There isn’t accountability or responsibility attached to these recommendations. The HSE is a very big organisation; who is responsible for carrying this out, when will it be done by and where is the accountability? I would have liked to see this in the report,” he said.

He insisted a degree of political will must come into the frame, “someone who can actually make things happen”.

“We don’t have the facilities or the back-up we need to provide world-class services,” he said. “I think this is the best opportunity we have ever had; there is more interest now in maternity services than there has ever been and I think it is really sad that it has taken something like the Savita case to get us to this point.”

Meanwhile, Dr Peter Boylan, consultant obstetrician and clinical director at the National Maternity Hospital, said the Hiqa report was an “appalling indictment of State failures over many, many years”, particularly in terms of staffing numbers.

International standards
"If you take the minimum recommended number of consultant obstetricians, for example for the number of births not including gynaecology, there should be at least 200 in the State [as recommended by] internationally accepted standards . . .but there is about 120," he said.

He said the National Maternity Hospital has about eight consultants but equivalent hospitals in Denmark or Sweden have about 50. He also said that Ireland is behind international standards on the number of midwives, requiring a further 20 to 30 per cent.

Sinn Féin deputy leader Mary Lou McDonald said Hiqa’s report was “damning on all fronts”. “ The authors of the report have found it impossible to provide assurances that women are receiving safe or reliable care during and after pregnancy,” she said.

The Institute of Obstetricians and Gynecologists has said it would work closely with the Department of Health and HSE "as a matter of priority" on implementing the recommendations of the report.