Transferring higher-risk pregnancies from Portiuncula to other hospitals will continue for “some time”, the head of the health service has said, but could be reconsidered if conditions at the facility are improved.
Since the end of October, Portiuncula University Hospital has not been taking bookings from expectant mothers who are deemed to be in higher-risk categories.
The definition of a high-risk pregnancy is not clear cut, but often includes mothers who are older, have gestational diabetes, those with a high body-mass index and women who had Caesareans in previous pregnancies.
The decision to move this care came following the announcement of 12 reviews into the care given to women and babies at the Ballinasloe hospital.
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Seven of these reviews have been completed, with the remaining five due to be completed by March.
A summary report on five of the reviews highlighted a number of issues, including around communication, reliance on agency staff and oversight at the hospital’s maternity unit.
Speaking at the Oireachtas health committee on Wednesday morning, Bernard Gloster, chief executive of the Health Service Executive (HSE), said the decision to move these pregnancies to other hospitals, including Galway, was made on the “evidence of conditions” provided to him.
“Absent those, the decision would not have been made,” he said, adding that if those conditions were to change in the future, resuming services would be “open for discussion”.
Asked when it would be likely for such services to resume in Portiuncula, Mr Gloster said it would be “unfair” of him to try to put a time frame on it, and it would require the conditions for the decision to “substantially change”.
“It is impossible to estimate when that would be because of the scale of the repeated problem,” he said.
Issues at Portiuncula’s maternity unit have been “on and off” for 13 years, Mr Gloster said, and a report published in 2018 – known as the Walker report – highlighted many of the issues that have persisted in the recent report.
Mr Gloster said the health service has to “accept responsibility” for their role in these issues recurring.
“We came up short on the side of the sustainability on implementing recommendations,” he said. “I would be absolutely lying if I was to say anything different.”
There were two key “junctures” he would need to see before care for these higher-risk pregnancies could resume in this hospital, he said: ensuring a “reasonable level of assurance” around outcomes to women, and if the level of speciality available on the floor of the unit is comparable to the other 18 maternity units.
Asked by committee chairman, Pádraig Rice of the Social Democrats, if there were plans to close the Portiuncula unit completely, Mr Gloster said that if any unit continued to be dysfunctional after changes were made, then it would be closed. He added, however, that there were no plans to close the facility.
