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

Yes, but somewhere along the line the decision was made to take Portlaoise hospital out of the small hospital framework, even though it had been included for that specific reason. Four year later we find that HIQA's report makes the very same recommendation made previously in the context of the Mallow and Ennis hospitals reports which fed into the small hospitals framework. The Minister, Deputy Leo Varadkar, said last night that the concept of level 2 and level 3 hospitals was an outdated assessment of what a hospital was. That may well be the case now, but at the time that concept was the benchmark in terms of the number of clinical presentations, the number of procedures carried out and the competence and expertise that could be maintained within a hospital facility because of the numbers of patients presenting. All of this was known when the issue of moving Portlaoise hospital out of the small hospitals framework and exempting it arose. Let us be clear that it was exempted from the framework with political fanfare and that there was significant backslapping at committees and in this Chamber. However, when we read the report, we see that the difficulty was that the hospital was not being resourced as a level 3 hospital. That is stated clearly in the report. In the context of resourcing alone, the hospital should not have been maintained at level 3 because of the difficulties in it. The HSE lacked a clear strategy or vision for the hospital. It was regarded by the HSE as a model 3 hospital, one that could provide acute services for patients presenting with all manner of injuries and illnesses, including life support. However, HIQA's investigation found that it was not being funded, equipped or resourced to provide this range of services. The authority's investigation found a number of examples of how the hospital was not being resourced to safely provide services at the level that would be expected of a model 3 hospital. This led to unacceptable ongoing risks for patients attending the hospital, on which I elaborated previously. These reasons, the backslapping and the accolades attributed to some people for maintaining Portlaoise hospital as a level 3 hospital make it clear that it was all a pretence from start to finish. There was no maintenance of level 3 hospital services. There was this pretence by senior hospital management and the HSE and at political level, but we find there were unsafe practices on a continual basis which knowingly happened in Portlaoise, in the general hospital as well as maternity services, and that nothing was done about it.

The Minister of State made reference to this issue in her contribution and I raised it last night. Dr. Chris Fitzpatrick, a former master of maternity services in the Coombe hospital, went to the Minister for Health in December 2011 and highlighted the problems in Portlaoise and Mullingar hospitals and begged for assistance and support. I have not seen the report on that matter, but I know that it is available. I know that every effort was made by the then master of the Coombe hospital to ensure something was done. He pointed out that we needed to do something in both hospitals. That happened in December 2011 and the following week Dr. Fitzpatrick went to the CEO of the HSE and repeated the same message but nothing happened.

I would like to find out and intend to find out by way of an FOI request what effort was made to relay this information to the front line and promise to do something at that level. People have referred to red flags, but as he families, many others and I have said in the context of the health committee's investigations into this issue and HIQA's report, it was no longer a matter of red flags. Alarm bells had been ringing everywhere for a number of years, but there was a complete failure to react at every level. Mr. O'Brien almost tried to absolve the HSE by virtue of the fact that Portlaoise hospital had been exempted from the small hospitals framework. He mentioned this quite intentionally. I asked him on a number of occasions when the HSE could respond to the policy direction of the Government and state it could not implement the policy because it would lead to unsafe practices. He said he could not do this, that the HSE was obliged to implement the stated policy. However, it was obliged to pretend that it was a policy that could deliver a safe service. Every one of us here who has read the report, every one who has gathered information or who has been in contact with the Department of Health, the previous and current Ministers for Health, the previous CEO of the HSE and the current director general of the HSE knows that they were all informed that there was a chronic problem with basic patient safety in Portlaoise, in the general hospital and maternity services.

We owe a lot to the families who have suffered so much. The least we should do is be honest about the fact that we did know about what was hapening but did nothing about it. We must implement the recommendations made in HIQA's report. They must be implemented expeditiously to ensure there is safe practice. We owe it to all expectant women, now and in the future, to ensure maternity services are put on guard in terms of patient safety and to ensure that the maternity review that has been announced will be fully supported. We must ensure the recommendations it will bring forward will be executed. We cannot allow a situation where there is even the slightest doubt that maternity services are not up to the highest international standards possible.

We have a continual debate in the Chamber about the pretence that there are realistic budgets. The Minister told us last December that he had achieved a realistic budget, but that budget is already a busted flush. We may as well accept now at the end of May that it is completely off target and out of kilter with what is happening in the health service.

The pretence that we will not have a huge budget deficit at the end of the year may as well be stopped tonight. We should accept that we have to reprioritise and refocus investment in health because the Minister has other problems besides patient safety. There are patients lying on trolleys, and more than 11,000 people in Waterford have been waiting to see a consultant on an outpatient basis for over a year. There are huge problems in the system, and at the same time we have to reprioritise patient safety. I ask the Minister of State to go back to the Minister for Health and the Departments of Finance and Public Expenditure and Reform and tell them that it cannot be done with what she has been given because it is not a realistic budget. I commend the motion to the House.

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