Ms Laverne McGuinness:

I thank the committee for its invitation to attend this meeting. I am joined by my colleagues, Mr. Ian Carter, national director of acute hospital services, and Mr. David Walsh, regional director for performance and integration in Dublin-mid-Leinster.

The HSE welcomes in full the findings and recommendations of the report of the chief medical officer, CMO, Dr. Tony Holohan, regarding perinatal deaths and related matters in Portlaoise hospital's maternity services from 2006 to the present. As members will be aware, the CMO prepared this report at the request of the Minister for Health, Deputy Reilly. It recognises clear failures in how risk and patient safety were managed in Portlaoise hospital during the period in question. It concludes that, under the previous governance arrangements, the maternity services could not be considered safe and sustainable. A new management team was put in place last Friday to address this matter.

The HSE accepts that there were significant shortcomings in the cases referred to in the report, particularly regarding the level and quality of care afforded to the patients in question and to the substandard communications with their families. The staff of Portlaoise hospital apologised unreservedly to any family that experienced care below the expected standard in the past number of years. On behalf of the HSE, I wish to repeat this unreserved apology for the failings in the care outcomes experienced by the families concerned and for failing to ensure that prompt incident investigations were undertaken. I also wish to apologise unreservedly for the unacceptable communications with the families at a time when they most needed honesty, compassion and kindness. The fact that timely investigations did not happen is unacceptable.

The report makes 11 summary recommendations and Mr. Carter has overall responsibility for their implementation. Three relate to the Health Information and Quality Authority, HIQA, and eight to the HSE. Steps have already been taken by the HSE to implement these eight, with three already implemented. Work has commenced to progress the other five. The HSE welcomes the involvement of HIQA in respect of three of the recommendations and looks forward to its input.

A new management team was appointed last Friday on an interim basis in order to run the service. This team consists of Mr. Michael Knowles, who has taken up the position of general manager at the hospital. Previously, he was general manager in Naas General Hospital. Ms Angela Dunne takes up the post of director of midwifery. She was previously the assistant director of the Coombe Women and Infants University Hospital. This management team will remain until a new governance arrangement is put in place. Dialogue has already commenced with the Coombe Women and Infants University Hospital in order to provide support to Portlaoise in a collaborative working arrangement for the future. The new governance arrangements will bring the appropriate vigour to maternity services in Portlaoise hospital. This is essential to restore quickly any loss of confidence that has arisen among mothers, fathers, families and the wider community that it serves.

The report concludes that families and patients were treated in a poor and, at times, appalling manner with limited respect, kindness, courtesy and consideration. The director general of the HSE, Mr. Tony O'Brien, has recently written to all staff within the health services highlighting the importance of honestly communicating with patients and families. In his letter, he wrote that communication failures, such as those experienced by the families referenced in the report, "erodes public confidence in Health Services, lets down the public and lets down the service as a whole". He asked all staff to address together the fundamental issues of culture that lead to such communication failures. In this regard, the HSE has recently published its policy on open disclosure. The policy ensures that services embrace and support an open, timely and consistent approach to communicating with service users and their families when things go wrong in health care.

The HSE shares the concern of the CMO regarding the promptness of incident investigation. An incident management policy, which is currently being updated by the HSE's quality and safety directorate, intends to reinforce the importance of speedy incident investigations. Furthermore, the HSE is conducting its own review into many of the concerns detailed in the report. While we await completion of that review, the HSE wishes to make it clear that it will take appropriate disciplinary action against staff members should the review deem that such action is warranted.

This report has revealed unacceptable failings. I reassure the committee and the community served by Portlaoise hospital that we will work with the new management and staff to ensure that these failings do not recur. This concludes my opening statement and, together with my colleagues, I will take any question members may have.