The problems with Portlaoise hospital are not confined to its maternity unit, and the problems with maternity services are not confined to the midlands hospital alone, according to the Health Information and Quality Authority.
While Portlaoise was safe for the vast majority of patients with straightforward cases, this was not always the situation for those with complex obstetric or surgical issues, according to members of the Hiqa team that investigated the hospital.
UK obstetrician Prof James Walker said the hospital was safe "for the majority of patients" in the maternity ward who didn't require complex skills on the part of staff. Over the past year, the unit had become safer as it improved its ability to transfer people requiring greater levels of care to other hospitals.
The same problems as had occurred in Portlaoise were to be found “across the country”, Prof Walker told a press conference yesterday. The fundamental problem was a lack of an overall maternity strategy.
Badly organised
Another member of the team, healthcare consultant
Martin Turner
, said he had never seen as organisation as badly organised as the HSE. Mr Turner said it was clear the HSE had no clear direction and was “not a learning organisation”. Portlaoise was “just coping” and “not a lot” had changed in the past year in terms of oversight.
While austerity had played a part in the problems that arose, that didn’t mean quality and safety of services were not to be prioritised, he said.
Another member of the team, patient advocate Margaret Murphy, described how the women who lost babies in the hospital suffered lasting effects, including an "unnatural fear" of having further children.
While they had a legitimate expectation of receiving appropriate, safe and effective care at the hands of skilled professionals, this proved not to be the case.
Ms Murphy spoke of recurring themes that emerged from the team’s discussions with the women, including their experience of a lack of compassion, empathy, dignity and respect, as well as deficiencies in communication, in the hospital.
The team spoke to eight women whose babies died, who spoke of how news of the deaths was unsatisfactorily communicated, often in inappropriate areas such as corridors, with an absence of psychological support.
Reprimanded for crying
Staff did not have the skills to help with bereavement and mothers described how they were reprimanded for crying in case it would upset others on the ward.
“In later contact with the hospital, when seeking answers as to why their baby had died, often they were given the impression they were isolated incidents, when in fact that was not the case. That their delivery was a stillborn when that was not the case. That internal investigations were in train, to later find this was not the case. They described defensiveness, cover-up and unfulfilled assurances, all of which resulted in their confidence being eroded and a significant lack of trust.”
Hiqa chief executive Phelim Quinn said the report shone a light on “unacceptable” standards of care in Portlaoise, and its publication as a “seminal moment” in placing quality and safety on the agenda of the health system.
