Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for coming to the House. I fully understand that the Minister is not available. I wish to raise the report on maternity services at Portlaoise. The report includes a recommendation that the Institute of Obstetricians and Gynaecologists made in its report on the future of maternity and gynaecological services in Ireland. The institute recommended, in December 2006, that clinical maternity networks should be established in Ireland. It also recommended that the maternity department at Portlaoise hospital be linked with the Coombe Women and Infants University Hospital in Dublin. This recommendation to establish clinical maternity networks was not progressed at national level. Some eight years later, in 2014, and in light of the range of adverse incidents highlighted earlier in the report, the report of the chief medical officer repeated the recommendation.

My concern this morning relates to the Portlaoise report. The report recommends that each of 19 maternity units throughout the country should have a director of midwifery. My understanding is that eight of the 19 units still have not appointed such a director. Part of the problem, as I understand it, is that the criteria for those who qualify for the job have been set so high that we cannot attract suitable candidates, especially in respect of the smaller units.

I raised this matter at the Joint Oireachtas Committee on Health four or five weeks ago. Some alterations have been made in the criteria. I still do not believe that we will be able to fill the eight vacant positions despite the new criteria. We seem to be going on the line that a candidate must be at clinical nurse manager 3 level for a number of years before she can go forward for this job. There are staff who have maternity experience but who may have been working in a managerial capacity in other areas within hospitals and dealing with patients on a daily basis. These people are now excluded from applying for the jobs to which I refer. I am suggesting that we must be practical, especially regarding the criteria we set out for the smaller units. A recommendation was made in 2006. I want to avoid a repeat of the situation whereby action had still not bee taken eight years after that recommendation was made. We found ourselves in an unmerciful mess in the context of trying to sort out a major difficulty with a hospital. I do not want another report to be put on a shelf or to have to come back to the Minister 12 months from now only to find out that the positions are still vacant. That is the context in which I am raising this issue.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Senator Colm Burke for giving me the opportunity to address the vital issue of the implementation of the report by the Health Information and Quality Authority, HIQA, into the services being provided at the Midland Regional Hospital, Portlaoise. As the Senator will be aware, on Monday, HIQA published a review of the progress that has been made at the hospital in implementing the various recommendations made following the its investigation in 2015. This report was conducted following a request from the Department of Health. The Department has been overseeing the implementation of the recommendations in the original report to examine the progress that has been made at Midland Regional Hospital, Portlaoise. I very much welcome this report, which has found that additional funding and staff have been provided for the hospital and that significant progress has been made in respect of governance, patient safety and quality.

I wish to acknowledge the reason we have travelled this far. It is thanks to the bravery of the families who spoke out in the midst of their grief. I have met and spoken to some of these people. In particular, I commend the maternity services. The report has described the services as providing care in a much safer and sustainable manner.Portlaoise maternity services are reporting monthly maternity patient safety statements and are participating in national data collections, including the Irish maternity indicator system. This has led to a confirmation by HIQA that the hospital’s maternity services are performing in line with nationally reported rates.

The extent of progress in patient safety measures demonstrates the commitment of the staff and the leadership team at Portlaoise hospital and the team at hospital group level. Both the Department of Health and the HSE are committed to securing and developing the role of Portlaoise hospital within the Dublin Midlands Hospital Group.

The HIQA report also identified immediate issues to be addressed in general hospital services. The HSE has been asked to address these immediate issues as a priority, and to ensure that the hospital is appropriately supported in that role by the other hospitals in the group to serve the patients of the midlands. Hospital funding has increased by 15% since 2012 and staffing levels have increased by 18%. Additional funding is also to be provided to facilitate the opening of the new medical assessment unit in the hospital in 2017.

The hospital group has produced a draft action plan for the hospital which takes account of the need to develop services in the context of developing the model of service provision for the entire group. The HSE has submitted the draft plan to the Department where it will be reviewed in detail.

With regard to the question the Senator asked concerning the appointment of directors of midwifery, five such positions were in place at the time the recommendation was made and, to date, seven additional candidates have been selected. A series of recruitment competitions are continuing to appoint people to the remaining seven positions to ensure all our maternity hospitals have senior midwifery decision makers.

I am happy to share the Senator's concerns about qualification standards with the Minister.

Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for her reply. She said there are seven vacancies. The health committee was informed that there were only three or four vacancies. There should be clarity and transparency about this. The hospitals that have not filled these vacancies should be clearly identified along with the timescale for filling them. When will the recommendations be fully accepted? I do not want a scenario where we are trying to fill these positions eight years later with some only being filled on a temporary basis in order that the same problem that arose in Portlaoise does not arise again.

The report highlights the variation in the delivery rate in Portlaoise hospital between 2007 and 2013 but it did not refer to the rate between 2000 and 2007 when it increased by more than 100%. The number of deliveries increased from more than 1,000 to more than 2,000. No HSE manager was held responsible for the failure to appoint additional staff. No one is being held accountable now for the failure to fill these vacancies. There should be clear accountability and a clear timescale to fill them.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The information I have provided has been gleaned from the HSE and I will get clarification on the outstanding vacant positions for the Senator.