Tánaiste Eamon Gilmore has raised the possibility of amalgamating some of the State's 19 maternity hospitals in the aftermath of the report on the death of Savita Halappanavar.
He said the report’s recommendations must be implemented to ensure that what happened would never happen again.
“For example, one of the issues raised in the report, in terms of the deployment of our resources, was whether we should continue to have 19 maternity hospitals or units in the country.’’
Mr Gilmore said it was an issue for everybody in the Dáil and asked what would happen if Minister for Health Dr James Reilly came into the House and said he wanted to have a smaller number of better equipped, better quality and better standard maternity hospitals. "Let us ask ourselves in all honesty what the response to that would be.''
Sinn Féin health spokeswoman Mary Lou McDonald said Mr Gilmore was right to raise questions about how the safety required was arrived at.
“However, I put it to the Tánaiste, and I know from experience, that for a heavily pregnant woman, the prospect of having to travel hundreds of kilometres to get to a maternity service or hospital would not be a helpful or a terribly safe thing for her to do.”
Mr Gilmore said responsibility for the implementation of the recommendations rested primarily with the Minister, the HSE management and so on.
“There may also be issues of choice, general policy and the deployment of resources that will ultimately be issues for everyone in the House,” Mr Gilmore added. “When we come to address those issues, we should do so with the best interests of the patient and of women at heart.’’
Mr Gilmore suggested that the Oireachtas health committee hold hearings on the report and also address the implementation of the recommendations.
Fianna Fáil health spokesman Billy Kelleher said the report made difficult reading for the Halappanavar family and many others, especially women and those involved in the provision of frontline maternity care services.
Highlighted deficiencies
He said the report highlighted deficiencies in the implementation of guidelines in the areas of sepsis. Another key issue highlighted was a lack of resources which was creating significant pressure on the delivery of frontline services. The issue had been raised by the masters of the Rotunda and Holles Street hospitals and other obstetricians.
Mr Kelleher said there should be the immediate establishment of an implementation body to assess and review the HSE’s commitments to implement the plans it had outlined.
Mr Gilmore said the report had noted a general lack of provision of basic fundamental care, such as the failure to follow up on blood tests, failure to recognise that Ms Halappanavar was at risk of clinical deterioration and to act or escalate concerns to an appropriately qualified clinician when she was showing signs of clinical deterioration.
Clinical accountability
The report had also referred to ultimate clinical accountability resting with the obstetrician who was leading the case. "When one reads these points, one must ask fundamental questions about whether someone was not doing his or her job or not doing it properly.''
Ms McDonald said they now saw a mirror held up to the maternity services, showing clearly that the vital safeguards, and the most basic provisions in terms of good governance and good practice in maternity services, were simply not there. She said it was about accountability and, crucially, resources.
