The Health Service Executive (HSE) is refusing to disclose the outcome of a process set up to determine whether any of its staff had a case to answer for a series of avoidable baby deaths at Portlaoise hospital.
The process, comprising an investigation by an external review group followed by a HSE disciplinary process, was supposed to be completed in three months, but ended up lasting more than three years.
The Portlaoise Review Group found six members of staff had a case to answer in relation to the deaths at Portlaoise, according to informed sources.
The group was established in response to calls from families who lost babies in the hospital for staff to be held accountable for the events leading to their deaths.
The group’s findings were passed to the human resources division of the HSE, which assessed the cases against individual staff under the terms of the organisation’s disciplinary code.
Although this process is believed to be complete, the HSE has declined to provide information about its outcome.
Adverse events
Róisín Molloy, whose son Mark died shortly after birth in Portlaoise hospital in 2012 and who has campaigned since for reforms including greater accountability, said the issue had been allowed to “fall by the wayside”.
“It’s as though the scandal never happened. But how quickly can you forget the deaths of healthy babies?”
The involvement of the HSE in determining whether staff had a case to answer was like the “putting fox in charge of the hen-house,” she said.
The deaths of five babies in Portlaoise were reported in 2014 in a RTÉ documentary, and scores of women subsequently came forward with stories of adverse events in the maternity unit, including further deaths.
While professional issues relating to doctors and nurses can be referred to the Medical Council and the Nursing and Midwifery Board of Ireland respectively, there is no equivalent process for managerial staff.
A number of staff who were criticised in reports on the scandal were subsequently promoted.
The HSE investigation began in July 2015 when three former National Health Service managers from the UK were appointed to determine whether any HSE staff had a clinical or managerial case to answer in relation to the deaths.
Their report cost €400,000, including almost €100,000 in legal fees.
HSE process
The delay in completing the investigation means a number of staff who were under investigation have retired, and are no longer subject to the HSE disciplinary procedure, if it was found they had a case to answer.
A HSE spokeswoman said the review group had complied with its terms of reference.
“They considered the material and interviewed staff to determine whether or not any employee had a clinical or managerial case to answer.
“This was not a process involving patients or family members of patients. This was a process conducted within the HSE disciplinary procedure and not otherwise. The process was comprehensive and undertaken by experts appointed by the HSE for this purpose.”
The group identified social and economic circumstances, the lack of effective strategy and “cultural and systemic issues” as having been “particularly significant” in what had happened at the hospital, according to the spokeswoman.
Efforts have been made by Portlaoise hospital to improve practices after 2012, she added.
The HSE disciplinary procedure comprises four stages – oral warning, written warning, final written warning and dismissal.