Staffing levels not responsible for all issues at Portlaoise

Staffing levels contributed to failings in maternity services at the Midland Regional Hospital in Portlaoise but did not explain the attitude and culture that had developed at the institution, Minister for Health James Reilly has said.

Speaking today at the Joint Oireachtas Committee on Health and Children, during a discussion on a report into the deaths of a number of babies at the hospital, Dr Reilly said there had been a “huge breach of trust” at many levels in the way services were provided in Portlaoise.

The Minister said the “root of the problem” in the hospital was that reports identifying concerns about the provision of care were carried out and recommendations were made but were ignored.

He said the information was available but nobody was collating it. Dr Reilly said the bravery of parents or somebody working in the hospital was needed to alert national authorities to the problems.

Dr Reilly said a monitoring system was needed to ensure individual recommendations made following incidents at hospitals were implemented.

“I think in the past it was the case that when issues in hospitals became unsafe, reports were done to confirm the fact they were unsafe and then used to close them down,” he said. “This is not going to be the case here. This report is going to be used to fix the service.”

He vowed to rebuild services at Portlaoise and turn the hospital into “an exemplar” over the coming years.

The committee was discussing a report ordered after an RTÉ Prime Time investigation found four babies died at the hospital between 2007 and 2012.

The report, by Department of Health chief medical officer Tony Holohan, found maternity services at the hospital could not be regarded as safe under their current governance arrangements.

It also stated that families and patients had been treated in a poor and, at times, appalling manner, with limited respect, kindness, courtesy and consideration. Information that should have been given to families had been withheld for no justifiable reason, it found.

A number of committee members raised concerns about staffing levels at the hospital, which saw the number of births rise rapidly in the last decade as the population grew dramatically but staffing levels did not.

Dr Reilly said nobody was saying staffing levels did not have an impact on service provision but that it did not explain everything.

“It doesn’t explain how that when there was nobody else on that unit on a given night how these failures occurred. It doesn’t explain the culture and attitude...what was done was just unacceptable at a human level and we have to change that,” he said.

Fine Gael TD Catherine Byrne said she was shocked by the lack of compassion displayed by staff at the Portlaoise hospital and that she was pleased to hear some staff might face disciplinary action.

Dr Reilly said compassion was needed in such situations but that safety of patients was most important as “no amount of compassion can make up for incompetence”.

He said there needed to be “a balancing act” and that people should be reprimanded when they did something wrong.

However, he did not want to see “a witch hunt” as morale among the many good people working there needed to be protected.

Senator John Crown told the committee his mind had been blown by the report, which he described as “a whitewash”.

“This issue is not an isolated one and we have discussed that before. I was less than impressed with the response given following the (Halappanavar) tragedy in Galway and year and a quarter ago,” he said.

Dr Reilly said he regretted that some people thought the report was a whitewash.

“I certainly don’t think so. If you listen to the parents themselves...they had all their concerns written down and when they went through this report they were able to tick every box as it had been addressed,” he said.

Dr Holohan added: “I’m not saying staffing is not an issue but I am saying it is not the explanation for what happened here.

“We cannot allow ourselves to conclude that staffing allows [peoplew] to, in my view, abdicate their responsibility to look after people compassionately and kindly or indeed report harm to patients honestly or openly when it happens.”