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

I am sharing time with Deputy Fleming and Deputy Keaveney, with 15 minutes, ten minutes and 15 minutes respectively.

The motion condemns the withholding and concealment of information from the families. The Minister referred publically to these families being lied to, a very serious charge and something that needs to be addressed. At the end of the day behind all of our debates, statistics, reports, data and statements as well as press statements from the HSE, the Department of Health, the Minister and others are families who have had bereavements and who were treated in an appalling fashion locally, regionally and nationally by the HSE.

We heard the testimony of Róisín and Mark Molloy last week as well as from Ollie Kelly and Amy Delahunt whose babies died in the maternity unit in Portlaoise hospital. The Minister heard first-hand from many families and individuals who had terrible experiences in Portlaoise. What I found having listened to the families was that they do not want people simply to issue statements saying that action will be taken. They want accountability and they want to ensure that this does not happen again. They want commitments to the effect that everything will be done to ensure safe practice for maternity services in Portlaoise hospital and broadly across all maternity services in the country. There was a noble statement from the families who came before the health committee as well as many of the other families affected.

That is why we have put down this motion. Over many years, many people sitting on the other side of the House from all sides and none have said they would act now and that enough was enough. Watersheds have often been mentioned. We have crossed the Rubicon on many occasions. The problem is that we are still in the Po Valley and we are still waiting for the implementation of many of the recommendations made by HIQA in previous reports. These have been outlined in the report itself. We have had investigations on many occasions, for example, in the context of Ennis and Savita Halappanavar in Galway. We had reports into the misreading of mammograms.

The one common thread in all of them is that the implementation of the recommendations has been very poor.

In many cases, there have been appalling efforts by policy-makers, those who provide the resources and those who implement the policy of the Government. That is not good enough. We have to keep this matter to the fore to ensure we strive for greater standards than currently exist. Our maternity services are reasonably good but they are not excellent. There are still shortcomings, including in terms of resourcing and the attitude of the HSE when something goes wrong. We talk of open disclosure, accountability and many such things, yet when something goes wrong families are very often left dealing not only with the associated bereavement and trauma but also with the bureaucracy and callousness of the system when they try to gain access to information and find out the truth. Very often, an adversarial approach is taken until the families go to the steps of the court, where a settlement is made. There is never any admission of liability on the part of the HSE so the facts cannot ever come out.

We still do not have proper perinatal pathology services. That is wholly inadequate in this day and age. If a baby dies immediately post partum or pre partum, or just before or after labour, we do not have proper perinatal pathology services in place to carry out an investigation into what happened and share the information with other maternity services throughout the country. We must examine this also. I do not believe this is a recommendation in the report but it must be considered.

I have tried in this debate to focus on the problems. There is one problem that we must accept and address. Very often politicians play politics with health and health care. For many years, including before the last election, there was no doubt that people ran around the countryside making outlandish promises, pretending they could deliver on things although knowing full well they could not or, perhaps even worse, having no notion of implementing their promises. That is very distasteful when we discuss health services. In the context of the Ennis report, for example, posters were put up in counties stating people would die if the recommendations were implemented. The problem in the context of Portlaoise hospital itself was that it was recommended that it not be a level 3 hospital anymore. This was in the Ennis report and the Mallow hospital report but there was political interference at some level. To this day, I do not know who made the final decision.

Last week at the meeting of the health committee, Mr. O'Brien was quite clear. I asked him about this twice and twice he was concise and pointed in his approach. I learned a policy decision was made at political level and that the HSE was obligated to implement it but there were no resources made available. Somebody somewhere decided, against the best recommendations available in the context of the Ennis hospital report, that Portlaoise hospital would not be maintained as a level 3 hospital. Great emphasis was put on this political decision by the previous Minister, Deputy James Reilly, who said he would retain the hospital as a level 3 hospital and that HIQA could be dismissed to a certain extent. However, the problem was that there were no resources to follow the political decision, and the HSE was consequently left trying to pick up the pieces and pretend to the people of the midlands that they had a level 3 hospital. That is very serious.

Dr. Chris Fitzpatrick, who was Master of the Coombe Women and Infants University Hospital for a number of years, spoke last week. In 2011, he presented a report to the Department of Health. As far as I can ascertain, he presented it to the Minister and later to the CEO of the HSE. The report pointed out the inadequacies of the service in both Portlaoise and Mullingar hospitals. Dr. Fitzpatrick was highlighting safety issues in 2011. He presented the report to the Minister himself, from what I can gather, and subsequently met the then CEO the HSE to outline his genuine fears for patients. Nothing was acted upon. Despite this, there is a consistent pretence from those in charge in the Department of Health, at political level, and the HSE that they were not aware of this. The bottom line is that they were; everybody was aware and alarm bells were ringing loudly from Portlaoise. Nobody in the Department of Health or HSE headquarters was willing to listen and act on those alarm bells. When we hear of systems failures and red flags being raised that were not acted on, we should note the bottom line is that people failed to do their jobs, act and address the inadequacies and deficiencies in the maternity services in Portlaoise.

I have to agree with the Minister's statement that a lack of resources can never be blamed for the lack of compassion and basic humanity. That is true. There is no doubt that the manner in which some of the families were treated was disgusting. They were ignored in their time of bereavement and tragedy, and their treatment was cold and callous in many ways. They made an effort to try to extract information week in, week out, including by repeated e-mails and telephone calls. Telephone calls were ignored for many months. The bottom line is that the system was hoping the families would go away, or meekly go somewhere else and stop annoying HSE management. However, the families' tenacity and bravery ensured we are now discussing this issue in this forum. Last week, the families were adamant about what occurred. I asked them whether, if they had not pursued the matter to the level they did, we would be any wiser, and the pretence would still be continuing. I refer to the pretence that there is a level 3 hospital in Portlaoise, that it is fully safe, that management is working towards staffing it adequately, and that any family that has any difficulty is being treated humanely, compassionately and with a degree of dignity and respect. The bottom line, however, is that management did not bank on Róisín Molloy saying when she went home after her baby died that enough was enough and that she could not allow this to happen to any other family. For that, we should all be grateful.

The report recommends that a steering group be set up to address and assess maternity services in the State. The Minister announced this when he saw the draft report. He has stated there are now more obstetricians, midwifes and other health professionals in the maternity services, in addition to a dropping birth rate. That is a given, but we are still way off the ratios required to ensure we have the safest maternity services that possibly can be provided in this country. Therefore, we have an a lot of work to do in this regard.

This motion effectively calls for patient safety to be put first and for the Midland Regional Hospital, Portlaoise, to be resourced in a manner commensurate with its status as a level 3 hospital. We must stop the pretence. We are now talking about the Coombe hospital interacting with the hospitals in Portlaoise and Mullingar, as recommended by the previous Master of the Coombe, Dr. Fitzpatrick. Dr. Fitzpatrick said there should be some level of oversight and co-operation between the Coombe, Portlaoise and Mullingar hospitals. In fact, most of the recommendations and observations he and others made at the time in question were compiled and included in the CMO's report of 2013 on foot of the Molloys, Amy Delahunt, Oliver Kelly and others coming forward and the pressure that was put on in the context of the "Prime Time" programme. There were people who were not calling for the sun, moon and stars but who were simply begging for help to ensure that the services would be made as safe as possible.

There is political accountability required. The previous Minister for Health did make political decisions that need to be explained. I cannot ask him to explain so I must now ask the current Minister to explain why Portlaoise was picked out of the ten hospitals that were named in the Ennis hospital report.

Why was it singled out for special treatment in terms of retention of level 3 status but no resources provided for it because it is critically important? If one allows political interference in terms of who gets health care and where health care is provided, if something goes wrong, that person should be held accountable. There is no point in the Minister or I pretending that it was done for other than political reasons because all the experts recommended that it should be included in the list of ten hospitals. I could accept if the recommendation had been different and if the former Minister had followed through but the fact that he single-handedly boasted he was going to retain it but did not fund it at the level at which it should have been funded is simply unacceptable.

We are calling for the recommendations to be implemented and for the resourcing to be put in place to ensure the standards and safety in the Midland Regional Hospital in Portlaoise are maintained; that when alarm bells ring, people act; and that when they do not act, we do not consistently blame systems failures because of the inability of individuals to carry out their basic duties locally, regionally and nationally. There are still many questions to be answered and many people still have an obligation to come forward and explain their role in the unfortunate and tragic circumstances that unfolded in Portlaoise over many years.

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