Thursday 29 September 2016

HSE acts on patient risk at last - but the real test of safety is yet to come

Published 04/06/2015 | 02:30

HSE chief Tony O’Brien
HSE chief Tony O’Brien

The decision by the HSE to stop Portlaoise Hospital doing complex surgery and effectively downgrade its A&E is a signal that it is eventually listening to the patient safety watchdog, Hiqa.

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Among the scathing criticisms of the HSE in last month's Hiqa report on Portlaoise Hospital, where five babies died, was that it ignored warning bells and recommendations over many years to protect patients.

Now, at last, it is taking action - but it clearly has no other choice.

The political fallout, and the inevitable pre-election "save our hospital" campaign which will follow, is one the Government parties' candidates must grapple with. But patient safety can no longer be neglected.

It was quite clear from the Hiqa report that surgeons in Portlaoise were not seeing enough complex patients annually to maintain a level of expertise.

It is indisputable that low numbers mean less chance to exercise their skills in complicated operations.

The A&E department, according to an unpublished HSE report in 2014, was not properly resourced and did not have enough experienced staff . It said it was not "clinically sustainable".

The decision is not without risk, simply because there is no trust that the HSE or the Department of Health, which have done little to earn the confidence of the public, will execute the changes properly. It might even make safety worse.

We are told the closure of its A&E department overnight will not happen until early next year.

What will happen to patients who would previously have presented as emergencies to Portlaoise A&E between 8pm and 8am?

Dr Susan Reilly, who heads the hospital group Portlaoise is part of, has already spoken of the pressures faced by Tullamore Hospital and Tallaght Hospital. The proposed overnight closure will cause anxiety locally among people who fear they will be left stranded.

If the follow-through is done with the same level of inertia that is such a mark of the HSE and the Department of Health, then bungling could lead to a serious risk to the people of Co Laois.

The families who lost babies in Portlaoise maternity unit were the real catalysts for change.

If they had not been brave and dogged enough to highlight the risks, yesterday's announcement would probably never have happened.

The tragedy is that it took lives to be lost to force the HSE to act.

Irish Independent

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