Mary Butler (Waterford, Fianna Fail)

I thank the Deputy for raising this important issue. I welcome the opportunity to discuss the delivery of maternity services at Portiuncula University Hospital. There are 12 external reviews related to maternity care at Portiuncula. Seven of these reviews have now been completed. I understand the very natural worry that developments in Portiuncula may be causing for many women and families who attend or who had planned to attend for Portiuncula maternity hospital. I also acknowledge and offer support to those women who may have had devastating outcomes as a result of their care. I am very proud of having rolled out perinatal mental health support across all 19 maternity hospitals over the last six years across. These perinatal mental health supports are very important especially for first-time mothers, mothers who might be who might be nervous, mothers who might have mental health conditions and women who just might have anxiety. It is really important for them to be aware that those supports are there.

In January 2025, a highly experienced external management team was put in place to oversee and manage maternity services in Portiuncula. The team reports directly to the HSE west and north-west regional management and is responsible for managing and supporting all aspects of maternity, gynaecology and neonatal services at Portiuncula. This team will continue to oversee the work and services provided at the hospital. The maternity unit at Portiuncula is being fully supported in this regard.

The safety and quality of our maternity services are priorities. The steps that are being taken to support the unit are to ensure the safety of all women attending maternity services across the region. The HSE has advised that the work to implement recommendations arising from the reviews is in progress through the Portiuncula external management team and the regional women’s and children’s managed clinical and academic network.

An implementation team has been established to ensure the recommendations arising from all reviews are followed and to progress any changes required over the coming months. There are currently 52 recommendations, arising from the seven reviews completed to date. I take on board what the Deputy said about the 2018 Walker report. Some of them may be implemented but not sustained. He is quite right in saying this is all about governance and accountability. This is not a blame game. This is to support the staff who are supporting women and girls every day of the week to deliver their babies safely.

The implementation team will also oversee the transfer of care for women with higher risk pregnancies from Portiuncula to University Hospital Galway or the hospital of their choice. This is not a new approach. It is in line with the well-established pathways in place for the transfer of care of complex or higher risk pregnancies within the regional maternity network. This approach is being broadened to include women with a wider range of clinical factors known to contribute to higher risk pregnancies. The HSE has communicated this to the women and families booked at Portiuncula, while GPs have also been advised and may refer women to Portiuncula University Hospital for assessment of the appropriate pathway of care.

These changes mean that women in rural communities who previously attended Portiuncula may now need to travel to Galway, or another unit of their choice for their maternity care. This may result in additional travel demands for expectant mothers and their families. The HSE west and north-west, through the work of the implementation team, is considering additional supports to assist women affected to ensure a seamless transfer of care for women identified as having a higher risk pregnancy.

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