Wednesday 18 October 2017

Maternity services still existing under the radar

WHEN the country's health watchdog investigated the circumstances around the death of Savita Halappanavar and wider maternity practices last year, one of its findings was particularly startling.

It found that eight of the 19 maternity hospitals did not publish an annual report which would make public basic statistics about practices in the hospital as well as its safety record.

Although the hospitals were not named, the Irish Independent later found out which hospitals were not producing these reports. One of the hospitals was Portlaoise .

It underlined once again how maternity services still exist under the radar.

Yesterday, the HSE published its funding and development plan for all acute hospitals in 2014, but proposals for a review of maternity services get only a few short lines. It said the HSE is implementing, with all hospitals, the recommendations from a number of key reports on maternity services .

It promised to publish progress on these reports this year. The spotlight is welcome, but it is long overdue.

It took the report of the patient safety watchdog HIQA to call for the review of maternity services.

Ireland excels when it comes to the European birth rate and remains at the top of the league, although there is evidence the boom is waning.

HIQA pointed out that anecdotal evidence is that the maternity services are mainly safe, and adverse events happen relatively infrequently.

However, it found a worrying lack of information on what quality of care, outcomes and and standards are in place for patients who are at risk.

A major deficit was the lack of a national guideline on the management of infection, which can grip a patient such as Savita Halappanavar, and turn out to be life-threatening.

The cases in Portlaoise highlight the importance of training on foetal monitoring and the administration of syntocinon.

HIQA found other deficits such as the failure of maternity units to measure how long it takes to transfer a critically ill pregnant woman to intensive care. Not all hospitals have provided assurances about access to on-site diagnostics around the clock. In the background also is the low level of staffing in several of these units, and the ratio of obstetricians in maternity units.

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