Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I concur with Deputy Sean Fleming on the tragedies that unfolded in the maternity services at Portlaoise hospital over several years. Much of this could have been avoided if the red flags that were raised on numerous occasions had been addressed. These were not red flags but alarm bells over governance issues ringing continually.

The executive summary of the report states:

This current investigation found that the HSE – as the provider of healthcare services – failed to take decisive action on defining the role of Portlaoise hospital and its model of care in the context of the findings of previous investigations. Corporately Portlaoise hospital viewed itself as a model-3 hospital and was not included in the national smaller hospitals framework. Similar to a model-3 hospital, Portlaoise provided a full range of acute services to patients presenting with all manner of injury and illness, including life support. However, at the time of this investigation, the HSE had failed to resource the hospital sufficiently and to ensure that the governance arrangements in place could safely deliver such a model of care to patients. For example, up until July 2014 the emergency department at the hospital – which was open 24 hours a day seven days a week – only had a consultant in emergency medicine on site for six hours, four days a week.

Earlier, I raised issues about accountability and who is ultimately responsible for this with the Taoiseach. I do not want to point the finger at or cast aspersions on any one individual. However, it seems there was an alarming problem with governance at local, regional and national level. The issue of accountability has to be addressed. We cannot talk consistently about systems failure. If we do not have accountability at senior management level, then we will have systems failure consistently because there will be no sanction for people who are simply not doing their job. I do not want to scapegoat any individual but there is an obligation on us to ensure accountability is part and parcel of the remunerative packages of people in charge and to ensure compliance with good governance.

Again, I extend my sympathies to the families who bravely challenged the HSE on this issue. I will have much more to say about this at the health committee over the next several weeks, as well as on the inability of the HSE to support the families and to be up front with the flow of information to families in times of bereavement and tragedy.

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