As a result of repeated incidents and scandals, maternity care in the Republic is rightly seen as a bellwether for the state of our public health service. Numerous recommendations made following the death of Savita Halappanavar at University Hospital Galway in 2012 were designed to improve and standardise quality of care offered by the State's 19 maternity units.
It is disappointing therefore to read of further deficiencies identified by the Health Information and Quality Authority (Hiqa) at the Coombe Women and Infants University Hospital. An unannounced inspection visit in August concluded the hospital's operating theatres posed a safety risk and were not "fit for purpose".
Although by no means the oldest maternity hospital building in the State, a number of the teaching hospital’s operating rooms were built in 1967. These lack physical separation, with an open plan design meaning there is a regular flow of staff from one to the other.
Hiqa found the location of scrub-up stations means that doctors and midwives have to walk through one theatre to access the next, with a resultant threat to the maintenance of operative sterility.
Not all of the identified deficiencies require major infrastructural investment: open windows and doors that allow unfiltered air to circulate during surgery, a lack of bedpan washers in the surgical department and inappropriate storing of sterile supplies and equipment are examples where best practice could be initiated by tighter management at little or no cost.
The flagship hospital, however, does require capital investment to bring it up to an international quality standard. Some €15 million is needed to refurbish four theatres and to build two extra operating rooms.
Tellingly, it took a Hiqa inspection for the Health Service Executive to approve a previous funding application by the Coombe for the urgent redevelopment. But the executive has yet to indicate when the money will be made available to enable the work to begin. This is yet another example of how a dysfunctional HSE fails to protect vulnerable patients.