External reviews into the deliveries of six babies at Portiuncula University Hospital in Ballinasloe will be a cause of anxiety for the roughly 800 women scheduled to give birth at the hospital in the coming months.
Since 2024, seven babies have suffered neurological injuries due to a lack of oxygen during birth at Portiuncula; an incidence significantly higher than national or international norms.
Another two babies were stillborn.
The Health Service Executive – which is responsible for the hospital – has appointed an external management team, led by a consultant from another hospital, to oversee maternity services at Portiuncula. Hopefully this will assuage concerns.
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It is important not to pre-judge the outcome of the reviews, but they must go beyond simply establishing what happened in the nine cases.
It is imperative to find out if lessons were learned from reviews carried out into eight similar cases between 2019 and 2023. Equally, were serious failures identified by a 2018 review into the delivery and neonatal care of 18 babies, three of whom died, addressed by the hospital?
The 2018 review identified problems with staffing, training and poor communication. Staffing is a chronic problem across the health service and is particularly acute at hospitals, such as Portiuncula, in smaller urban areas. A quarter of consultant posts in these hospitals are staffed by locums, according to a report published by the HSE last year, though simply creating more consultant posts at Portiuncula will not solve the problem.
The issues raised at Portiuncula will revive debate over the viability of the HSE’s regional hospital group model. Under this model, hospitals located in smaller urban areas provide acute services such as maternity care.
More complex or specialist cases are referred to larger hospitals – located in large urban areas – within the same group. In the case of Saolta Hospital Group – that covers the West and North-West and includes Portiuncula – it is University Hospital Galway.
Transferring maternity services in their entirety from Portiuncula to Galway is possible and could alleviate the recruitment problem. However, any attempt to do so would doubtlessly be opposed by the local community. And concerns are understandable.
If service provision is to change, the public must be persuaded that improvement will follow. The seemingly intractable problems encountered by Limerick Hospital Group – which has adopted this strategy and downgraded its smaller hospitals – show this approach is not a panacea.
The immediate priority is to establish what happened at Portiuncula and why. Whatever proposed solutions then emerge must put the interests of mothers and babies first.
