Only four of the country’s nineteen maternity units are in proper buildings, a new report has revealed.
HIQA has published an overview of its inspections of Ireland’s 19 maternity units and hospitals.
The units which meet the infrastructure standards are in Cavan, Wexford, Drogheda and Cork but all the others need to be upgraded.
While HIQA found good practice in how maternity services detect and respond to obstetric emergencies, it also identified opportunities for improvement to ensure that maternity services remain safe and effective into the future.
The report notes the overall level of professionalism, teamwork and commitment displayed by staff providing maternity care across the country — in what is a highly pressurised and demanding environment.
Two maternity units – University Hospital Kerry and St Luke’s, Kilkenny – were identified as having particularly high levels of non-compliance with standards.
Foetal ultrasounds were not unavailable at five units.
Mary Dunnion, HIQA’s Director of Regulation, said: “Overall, our findings provide assurance that improvements have been made in maternity services since HIQA’s investigation into maternal care in Portlaoise Hospital. However, we found a lack of clarity and national leadership within the HSE regarding the responsibility for implementing the National Maternity Strategy.
"This Strategy provides a framework for a new and better maternity service that improves choice for women, and ensures that smaller maternity units, in particular, are better supported to provide sustainably high-quality and safe care.
“It was of concern to HIQA that the HSE had made only limited progress in advancing this Strategy since it was approved by Government in 2016, and a more comprehensive, time-bound and costed implementation plan is required.
"While more formalised governance structures were introduced by the HSE at the end of 2019 to improve national leadership in this area, the HSE must now implement the Strategy and establish maternity networks to ensure that pregnant women, mothers and newborns across the country have access to the same level of care and support regardless of where they live.”
Sean Egan, HIQA’s Head of Healthcare, said: “Our inspections showed that services around the country were reliant on front-line medical staff working onerous rosters — some on call every three nights — and midwifery staff working overtime to address staffing deficits and maintain service levels.
“In addition, the poor infrastructure and physical environment across maternity services significantly impacts on a woman’s comfort, dignity and privacy, and increases the potential risk of cross infection for women and babies. Addressing the ageing infrastructure across many maternity services will require significant funding.”
HIQA has made eight recommendations to the HSE to improve the quality and safety of maternity services into the future, including the development of a comprehensive plan to fully implement both the National Standards for Safer Better Maternity Services and the National Maternity Strategy.
Ms Dunnion added: “It is imperative that the HSE acts on HIQA’s eight recommendations in a timely manner to ensure that Irish maternity services are enhanced and placed on a more sustainable and equitable footing for women and their babies.”