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 Header Item Services for People with Disabilities (Continued)
 Header Item Hospital Staff

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

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  10 o’clock

(Speaker Continuing)

[Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch] Despite the fact that I take entire responsibility for the disability and mental health service,and how we need to transform it, what we inherited was chaotic. We inherited it from the party of which Deputy Colm Keaveney is now a member.

Deputy Colm Keaveney: Information on Colm Keaveney Zoom on Colm Keaveney There are fewer staff under the current Government.

Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch No one is responsible for the type of weather we have seen in the past few weeks. Coming from Cork, I know that better than most and, when there is an issue of health and safety, that will be dealt with as a matter of urgency. My information is that, as of this morning, it is being dealt with as we speak. This is why we are building a new 50-bed unit at the same site. There is no great disagreement between us and I know the Deputy wants the new unit and that he wants people treated properly, as do I. I am not responsible for the weather and all I can do is deal with the situation as I find it.

Deputy Colm Keaveney: Information on Colm Keaveney Zoom on Colm Keaveney What about the €3.1 million in St. Luke's?

Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch When I came into office, I found a service in chaos.

Hospital Staff

 5. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he has ascertained the actions that were taken in response to the concerns expressed by midwives in the Midlands Regional Hospital, Portlaoise, in 2006; the immediate action he will take to ensure best obstetric practice at this hospital; if he will ensure that the long signalled problem of under-staffing is addressed without delay; if he will initiate a Health Information and Quality Authority inquiry; and if he will make a statement on the matter. [6981/14]

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin This question concerns whether the current Minister for Health has ascertained what actions, if any, were taken by his predecessor, the then Minister for Health, Mary Harney, in response to concerns about midwifery staff at the Midlands Regional Hospital, Portlaoise, and what action he is willing to take to address the long-signalled problem of understaffing at the facility.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am aware that the previous Minister for Health received representations from the then Minister for Finance in 2006 about the maternity unit at Portlaoise. As overall responsibility for the management and delivery of health services rests with the HSE, the correspondence was forwarded to the executive for attention, as appropriate. The HSE replied directly to the Minister for Finance, acknowledging difficulties at the hospital and outlining proposals to address the situation, including the recruitment of additional midwifery staff and some upgrading of the maternity facilities.

With regard to current staffing at the Portlaoise maternity unit, I understand from the HSE that a number of vacancies exist at present and that service provision is supported by agency midwives. However, the hospital has approval to recruit additional midwives up to the approved complement and this recruitment process is ongoing.

I assure the Deputy that actions are being undertaken across our health services with a view to improving patient safety and providing a more patient-centred model of care. In particular, patient safety has been made a priority within the HSE's annual service plan through specific measures focused on quality and patient safety. My Department is leading the development of a code of governance which will clearly set out employers' responsibilities in achieving optimal safety culture, governance and performance. I have asked HIQA to ensure that my patient safety priorities are included in the monitoring programme against the national standards for safer better health care. I have instructed the national clinical effectiveness committee to commission and quality-assure four priority national guidelines on sepsis, clinical handover, maternal early warning score and paediatric early warning score. This body of work is in progress and well advanced.

My Department, in conjunction with the HSE, is developing a new national maternity strategy to provide the strategic direction for the optimal development of our maternity services. In light of the reports of a number of perinatal deaths at the hospital in recent years, I have asked the Chief Medical Officer to provide me with a report on the issues arising as quickly as possible. This report will inform the terms of reference of any subsequent HIQA review into the issue.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I extend my deepest sympathy to the four families we know of who lost infants in tragic circumstances in the Midlands Regional Hospital, Portlaoise. As the parents stated, they have been treated disgracefully in their words, which are absolutely correct. They were kept in the dark about how and why they suffered these tragic losses. The HSE has admitted serious failings and I ask the Minister whether this underlines the absolute need for full openness and transparency in the investigation of what happened and why. That needs to be established quickly. The revelation that staff at Portlaoise hospital had already raised the alarm and wrote to Brian Cowen and Mary Harney about concerns about obstetric care in 2006 is alarming, given that it has not been satisfactorily addressed in the years since. When was the Minister made aware of the previous representation and identified need? When was he made aware of the actual need in his role as Minister since he took office?

I noted at the health committee meeting last week that the scop of Dr. Holohan's report had not been worked out. It should include all relevant issues. Will the Minister confirm that it will include the inadequate staffing levels at the hospital?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly There is a report being compiled by the Chief Medical Officer. He and I met three of the families concerned. Like the Deputy, I reiterate my sympathies on their losses and I apologise for the way they were treated subsequent to their losses. I am committed to a transparent and accountable health service and a patient safety agency that will be set up in the next quarter so that patients have an advocate they can go to and so that what happened in Portlaoise can never happen again. If someone has a complaint and it is not being dealt with expeditiously by the people concerned, the person can go to the patient safety agency to receive help, advice, support and encouragement to pursue the issue to its natural conclusion. I assure the House, the Deputy, the families concerned and the broader public that we will get to the bottom of this and that we will find out where are the issues and problems and that we will fix them. Unlike before, we will not use the report to downgrade and undermine the hospital further but rather to support it to deliver services that the great people who work there, in many instances, are striving to deliver.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I welcome the last remarks by the Minister. Only in the fullness of time will we have the opportunity to test them but I hope the commitment will be delivered upon. Will the Minister confirm the scope of the report of the Chief Medical Officer? Will it include address of the staffing levels and understaffing over the number of years involved? It is crucial to establishing the full facts. In his first reply, the Minister said staffing issues are being addressed. I note that he referred to "up to the approved complement" in his first response to the question. My understanding is that the current ratio of midwives to births is 1:55, when the internationally recognised norm is 1:29. What is the Minister referring to when he says staffing levels are being increased up to the approved complement? Whose approval and whose standards? It is hugely important that we know exactly what we are talking about. What are we talking about? Will the Minister quantify the number of new midwives expected? Where does it come in the internationally recommended norm of 1:29 births?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I assure everyone that the Chief Medical Officer's report will be comprehensive and it will be an important signpost for HIQA when it engages in its review of the situation in Portlaoise. It is in everyone's interests that the problem not just be addressed but fixed so that people can have confidence into the future in that hospital and in all our maternity services. I thank the families for taking the time to speak to me and the Chief Medical Officer. Their contribution and their story, which was harrowing to go through again, has informed the Chief Medical Officer of the issues he must address and it will allow him to address it in a comprehensive way, which might not have been possible without the benefit of their time.


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