The Government is facing a politically contentious decision in the Midlands after an official report raised concerns over safety standards at Midland Regional Hospital Portlaoise.
The hospital is at a “critical juncture” and faces an “uncertain” future because of continuing safety concerns, according to the report by the Health Information and Quality Authority (Hiqa).
An action plan submitted by Dublin Midlands Hospital Group to the Department of Health proposes major changes to the hospital, with one source saying only 80 per cent of current services will survive if it is implemented.
The Portlaoise Hospital Action Group, which believes the plan proposes an end to the current 24/7 emergency service at the hospital, has vowed to campaign against any cutbacks.
One option for the Government is to rationalise services, as favoured by clinical decision-makers on safety grounds and in recognition of the extreme difficulties in recruiting qualified staff. However, Minister for Foreign Affairs Charlie Flanagan, the local TD, has called on the Health Service Executive to invest further in the hospital, even though it has benefited from significant extra funding in recent years.
Safety questioned
Hiqa issued its warning after again publishing a report calling into question the safety of emergency and critical care services at the hospital. The authority said the intensive care unit at the hospital does not meet minimum standards and has questioned whether the critical care services can continue.
“The status quo is not an acceptable long-term situation from a patient safety point of view, and the ongoing uncertainty that results from the lack of a long-term plan is damaging for the hospital and impacts on current service sustainability.”
In a report reviewing progress on recommendations it made last year in the wake of a series of baby deaths at Portlaoise, Hiqa says there have been some improvements in maternity services.
However, the sustainability of other clinical services has been hit by a lack of certainty over future plans and a knock-on effect on staff recruitment and morale.
The report was carried out in order to support the provision of safe and quality services in Portlaoise, according to Hiqa's director of regulation, Mary Dunnion. "While some progress has been made, significant risks remain and the future of the hospital is uncertain."
Maternity services
The report says maternity services are now being provided in a safer and more sustainable way as a result of better leadership, increased investment and an improvement in the staff-to-birth ratio driven by a reduced number of births.
It says more needs to be done to progress the integration of the maternity unit with that of the Coombe Maternity Hospital in Dublin.
According to Hiqa, many of the risks it identified in 2015 in relation to critical care and emergency services remain unchanged. The most significant change since then has been the cessation of complex surgery but otherwise “only limited change” to the provision of general services has occurred.
The HSE said in a statement it welcomed the publication of the review and detailed the progress made to meet the recommendations including “significant improvements” in corporate and clinical governance, and management structures.
Mark Molloy, who has campaigned with his wife Roisin for better services at the hospital since the death of their baby, Mark, in January 2012, said they were disappointed at at the outcome of the Hiqa report.
“We’re very disappointed at the findings in the report and the fact that it took this long,” Mr Molloy said. “Families went to great lengths to ensure this report happened. But there are a number of issues here – the uncertainty of the future of the hospital, which makes it hard to attract staff, and the reputational damage that has been done.”
