Ms Mary Dunnion:

Most of the CMO report was concerned with national recommendations, many of which would have been aligned with the maternity strategy and would have been identified by the authority as far back as 2013.

In the context of the recommendations in the CMO's report, some changes were made in the maternity hospital and benefits were noted. Let me give an example. One recommendation the CMO made was to have an interim management team for the maternity service. He identified significant deficits in the governance arrangements. What was disappointing for the investigation team was that, while that happened in the maternity service, the same governance arrangements remained unchanged in the general hospital because the interim management team was specific to maternity services. However, one could see the benefits of having an effective management team, a director of midwifery and a risk manager come on board in the maternity service. They are reflected in the report.

The recommendations were taken on board but the one that was of considerable concern to us concerned the networking into a clinical network, as in the case of the Coombe hospital. While we appreciated the difficulties that would arise in the context of a voluntary and statutory hospital and setting up those arrangements, we were significantly concerned about the lack of senior clinical leadership. This was reinforced by the clinical expertise of two obstetricians on the investigation team. We regard clinical leadership as an integral part of the important process of driving best practice, clinical supervision, clinical auditing and all the associated factors. We were so concerned because there was not senior clinical leadership with that level of experience in Portlaoise. The interfacing with the Coombe hospital had not happened. We wrote to the director general because we were concerned about this. Thankfully, at the latter end, four weeks before the publication of the report, the memorandum of understanding has been signed. Although it has not been implemented yet, we are aware that there is senior clinical leadership from the Coombe on-site in Portlaoise hospital. We very much welcome that development. However, we are obviously disappointed over how long it took.