Four Monaghan woman have lost a High Court bid to overturn a decision of the North Eastern Health Board to suspend maternity services at Monaghan General Hospital.
Mr Justice Ó Caoimh, in a reserved judgment yesterday, found that the Health Act, 1970, did not preclude the NEHB from taking its decision to suspend the maternity services at Monaghan. The women had not satisfied the court that the provision of maternity services at Cavan General Hospital was in breach of the Act.
The judge said it was clear that the board's decision was taken in the light of prevailing circumstances, particularly having regard to the decision of the hospital's insurers to withdraw cover so as to effectively preclude the continuance of maternity delivery services at the hospital.
The women who took the action, which was backed by the Monaghan General Hospital Development Committee, were Ms Shauna Tierney, McCurtain Street, Clones; Ms Maura Sherlock, Tirnaskea, Tydavnet, Ms Brenda McAnespie, Lake-view, Emyvale, and Ms Sharon O'Neill, Oriel Park, Emyvale.
Costs of the two-day action, estimated at between €50,000 to €60,000, were awarded to the health board. A stay on the decision was granted pending the women's decision on whether to appeal to the Supreme Court.
Mr Justice Ó Caoimh said the general obligations on health boards to provide services must be construed on a rational basis.
A health board must be able to choose where the provision in question would take place, as long as this did not preclude the provision of the service for women living in its catchment area.
Consultant-led delivery services at the hospital had been discontinued in circumstances "where it must be doubtful that such services will be reinstituted in the future". It appeared the health board sought to provide some maternity service in Monaghan and this remained its plan. A midwife-led maternity service was to be introduced in 2005.
Nowhere in the legislation was there any indication as to where the provision of a service was to take place, but it was clear the obligation was to provide services such as medical, surgical and mid-wife services, the judge said.
He did not consider a health board was restricted in relation to discontinuing services in a particular hospital provided it maintained the hospital as a hospital. It was clear, as time moved on, the need for services might change.
The essential issue was whether the board was precluded from discontinuing the services in question at Monaghan hospital on a temporary basis or otherwise. He found the board was not so precluded.
It appeared the decision to suspend temporarily the maternity services in 2001 was one which, in all likelihood, would have permanent effect insofar as "no indication exists that there is any proposal to reintroduce the consultant-led maternity service".
It was understandable that the four applicants would contend the decision described as a temporary measure was, in fact, one with a degree of permanence.
He accepted the decision was taken in a situation of some emergency and was not intended necessarily to have permanent effect.
The suspension of maternity services caused uproar in the county and led to several protests. It also led to a major controversy when an Emyvale woman, Ms Denise Kerry, was not allowed to deliver her baby at the hospital in December 2002, even though she was in an advanced stage of labour. Instead she was sent by ambulance on a 25-mile journey in the middle of the night to Cavan hospital. En route she gave birth to a premature baby girl who died shortly afterwards.