Background:A REPORT on the death of a 34-year-old woman within hours of delivering twins at Our Lady of Lourdes Hospital in Drogheda last year has again drawn attention to staffing deficits at the hospital.
The investigation team found maternity, paediatric and anaesthetic services are "significantly under-resourced to cope with the current demands" and that this had an impact on how Tania McCabe was cared for.
Ultimately, it said, the care provided to Tania was "compromised by [ the staff's] workload and the environment in which they were working".
This revelation, along with many others in the report, following a year-long investigation into the death of the young mother, will make for harrowing reading for her family.
But it will also enrage the many people who drew attention to staffing deficits at the hospital for the past few years, particularly in the hospital's maternity unit, but who saw no action being taken in response to the airing of their concerns.
Among the many who raised concerns were the hospital's medical board, the Kinder taskforce, An Board Altranais, and Judge Maureen Harding Clark, in the Lourdes Hospital Inquiry report.
In her report in January 2006, Judge Harding Clark noted that the maternity unit was "still under-resourced and understaffed" and she was "unimpressed by the unwieldy bureaucracy" around replacement and recruitment of staff.
Meanwhile, in a letter to the HSE in February 2007, just weeks before the untimely death of Ms McCabe, the hospital's medical board warned that patients at the hospital were being "exposed to a high level of risk across all departments" due to staffing shortages and infrastructural deficits.
They said that within the department of obstetrics, "midwife numbers are far short of national norms" and in critical care and anaesthesia there are "major risks" as a result of consultants being called to two emergencies at a time.
Furthermore, the medical board said the hospital urgently needed a clinical microbiologist, something now recommended again in the report of the inquiry into Ms McCabe's death.
And when An Board Altranais, the regulatory body for the nursing profession, visited the hospital in October 2006, it found staffing levels to be well short of recommended levels.
It noted there had been an increase of 104 per cent in births at the hospital over the 10 years to 2005, due to the closure of maternity services at the Louth County Hospital in Dundalk and at Monaghan General Hospital, as well as an increase in the population of the area the hospital serves. This area extends to north Dublin. Despite the increase in births, there had been no increase in beds and few extra midwives have been employed, it said.
The HSE's national hospitals office was also warned in October 2006 by Patrick Kinder, chairman of a taskforce set up to oversee the delivery of better maternity services in the northeast, that there was an "urgent need to review staffing and accommodation requirements" in the maternity unit at the Lourdes hospital, which he said had experienced a 90 per cent increase in births since 1999, but no equivalent increase in midwives.
He wrote that the high birth rates and low staffing levels showed "the extent of the serious risk which currently obtains in the maternity unit in Our Lady of Lourdes Hospital".
Meanwhile, only last month a consultant at the Lourdes hospital offered to give up part of his pay so that extra nurses could be employed at the hospital.
Dr David Vaughan said he was making the offer as he continued to be concerned "by the marked deficits in neonatal nursing and midwifery numbers" at the hospital.
The latest report to recommend an urgent improvement in medical and midwifery staffing levels at the hospital is the report into the death of Ms McCabe.
It notes that there were 57 midwives in the hospital to cope with 2,121 births in the year 2000 and 88.8 midwives budgeted for in 2007 to cope with 4,277 births. "The review team were concerned to hear about the history of poor response to staffing level deficits," the report says.
It now remains to be seen if the tragic death of this young woman, leaving behind a grieving husband and two young children, will finally stir the HSE into action.
But with tight controls recently imposed on recruitment in the HSE in order to cut costs, one couldn't have too much confidence in progress being made by it on these pressing issues anytime soon.