A highly critical report into a midlands hospital where five babies died in controversial circumstances has provoked a furious row between the Health Service Executive and the independent health regulator.
The HSE has threatened to take legal action to prevent the publication of the report by the Health Information and Quality Authority (Hiqa) into the Midland Regional Hospital in Portlaoise.
An advanced draft of the report places some of the blame for the shortcomings at the hospital on senior corporate management in the HSE, The Irish Times understands.
It says passivity among senior managers, constant changes in corporate structures within the health services and a lack of clear reporting relationships were contributory factors behind the problems at the hospital.
In a finding with considerable resource implications, the draft report says that while Portlaoise was nominally ranked as a general, regional hospital (level 3), it was funded only as a local hospital (level 2). Level 3 hospitals operate around the clock while level 2 hospitals normally provide services from 8am to 8pm only.
Former minister for health James Reilly commissioned the report over a year ago after his chief medical officer, Dr Tony Holohan, investigated a series of baby deaths in the maternity unit between 2006 and 2012 and found it was unsafe.
Publication delayed
The Hiqa report highlights problems not only in the maternity unit, but also in the emergency department and other areas of operations.
The six-person team which investigated the hospital completed its work some time ago, but the publication of the final report has been delayed for months while legal issues relating to due process are attended to.
The threat to injunct the publication of the report surfaced at a top-level meeting last Thursday between HSE staff and Department of Health officials. The HSE said it was one of a number of options being considered in response to the findings.
Warning
Department officials urged the HSE not to take legal proceedings and warned that if this happened, Minister for Health Leo Varadkar would be obliged to support Hiqa. The threat has been lifted for now pending the provision by Hiqa of further information to parties named in the report.
As a result, the publication of the report, which was planned next week, is likely to be delayed until next month.
Hiqa has circulated relevant findings to parties named in the report and asked for a response. The HSE is now seeking supporting documentation relating to the findings.
A HSE spokesman said it had engaged with Hiqa throughout the investigation. “As this process reaches the completion stage, there has naturally been a focus on ensuring that there has been full and comprehensive input. The HSE has sought all of the necessary information and documentation necessary to facilitate this.
“Hiqa and the HSE are now working in accordance with an agreed process to bring finality to the HSE’s input into the process of finalising the report.”
The investigations into the hospital were triggered by RTÉ Prime Time programmes last year into the deaths of five babies in the maternity unit. It was alleged that staff were unable to recognise or act on signs of foetal distress, which is monitored using a CTG machine, during labour. Hospital management repeatedly failed to act fully on recommendations to reduce the risk.
Portlaoise is one of a number of smaller hospitals where maternity services are under review following a series of adverse events.
