Friday 18 October 2019

We've seen it all before: HSE probe into deaths is too little too late

'If pregnant mums are at risk, our health system is failing us.' Stock image
'If pregnant mums are at risk, our health system is failing us.' Stock image
Deirdre Conroy

Deirdre Conroy

When you are pregnant, your doctor may well tell you that it is a natural condition, it is not an illness, you don't need to alter your lifestyle unless you smoke or drink heavily.

It is a long nine months, but the wait and the weight will be worth it. Some women will choose to have a natural labour, as in no medication, at home, even in a birthing pool, with the aid of a community midwife.

Others want to put themselves in the capable hands of the experts in a maternity hospital or maternity wing. There, they can be assured of labour management and emergency attention if anything should go awry.

The news that there have been two very recent baby deaths at Cavan General Hospital is very troubling - especially as we have had the Portlaoise General Hospital inquiry and new guidelines on systems and practice issued by the HSE.

In Cavan Hospital on Sunday morning, after medical issues arose during the mother's pregnancy, an emergency Caesarean section was needed. Huge strides have been made in this technique: it can be very successful, reduces the risk to the baby and is increasingly an elective procedure, based on the safety statistics. Ensuring a safe procedure requires skill and experience. This is not something a passing driver can do if you were to go into labour on the way to hospital.

In the baby's death on Sunday morning, the difficulties arose before the Caesarean could be carried out. In the earlier delivery, the baby died within a day of being born. It is not clear what was the cause, or if there was any pre-existing condition. It seems fair to assume that the baby was healthy, or else it would not have been reported.

News of these incidents comes at a time when the last thing any pregnant woman needs is a hospital or the HSE or the RCSI to close ranks. But previous experience has shown that is exactly what happens, just as in Portlaoise.

We have seen the HSE conduct such internal inquiries before: it takes years for any outcome, and the failure, delay, and miscommunication will have been dealt with too late. Nobody will be sanctioned.

Obviously, some baby deaths are not preventable and may be due to natural causes.

But Cavan General Hospital, which is one of the smallest maternity units in the country, has been the subject of at least four investigations into baby deaths in recent years.

A HSE 2014 survey showed Cavan had the second highest rate of Caesarean sections at 31.28pc, while Mayo General Hospital was highest at 31.78pc.

One would expect that a 'general hospital' in which maternity facilities are integral would at all times have an obstetric consultant capable of stepping in to deal with an emergency in the labour ward.

We can have all the 'centres of excellence' we like, but if we don't have the skilled staff present to deal with emergency surgery for a crisis at birth, what is the point of the capital investment?

While the details of these two tragic deaths are not fully known, if pregnant mothers are at risk because of under resourcing, unsuitably qualified staff or inadequate staff numbers, then our health system is failing us.

Irish Independent

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