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IRELAND’S HEALTHCARE WATCHDOG has said it cannot stand over the absolute safety and quality of maternity care because of a lack of information.
HIQA says it gathers statistics but that problems arise when dealing with maternal morbidity and sickness rates.
“We are saying that with the lack of information, it is very hard to absolutely give assurance on the quality and safety of services,” said Phelim Quinn, director of regulation.
“That is a key deficit in the system.”
He was speaking at the launch of a report into the death of Savita Halappanavar at University Hospital Galway last October.
“No doctor, nurse or healthcare worker will stand by and let their patient die,” Dr Nuala Lucas, a consulstant anesthetist, said when asked to comment on Praveen Halappanavar’s remarks that his wife was ‘left to die’ in her hospital bed.
“But if you don’t have the correct knowledge, guidelines and protocols in place…then things like this are going to happen,” she continued.
The authority’s chief executive Dr Tracey Cooper also noted that the 31-year-old dentist was treated on a “very busy” gynaecology ward even though she was a deteriorating obstetric patient.
The reality is that the staff…were not equipped around the knowledge of sepsis.
University Hospital Galway was one of 14 hospitals to not report full implementation of the recommendations of a 2007 report into the ‘strikingly similar’ case of Tania and Zach McCabe in Our Lady of Lourdes Hospital, Drogheda.
Although the hospital does have guidelines in place for the management of sepsis, they were not in use on St Monica’s Ward where Savita was treated.
The HIQA team behind the report believe that the outcome for the Galway resident could have been different.
“Young patients don’t just die,” said Dr Lucas. “They generally become ill and start down a slippery slope. You have opportunities to reverse that…that is what early-warning scores are all about. It is about picking up a patient before they become critical.”
One of the 32 recommendations to the HSE from the watchdog advises the hospital group to consider making appropriate referrals to the relevant professional regulatory bodies about the actions, omissions and practices of the medical staff involved in the care of Savita Halappanavar.
Quinn explained that HIQA wants an “open and just” system of care and part of that would be referrals when there are significant failures.
He noted that the referrals may have already taken place following the HSE investigation and inquest but that his body had also forwarded a copy of their recommendations to highlight concerns.
It is up to each individual body then, he said, to examine and assess if those concerns and actions meet the threshold to alter fitness to practice.
Lucas also outlined her worries about inadequate staffing levels in hospitals, noting that there was a wider picture than just one-on-one care.
Having a sufficient number of consultants will improve a hospital’s services as a whole, including clinical care, education, training, nurse management and local guidelines, she said.
The HSE has been called on to review its workforce arrangements for maternity services nationally to ensure there are adequate numbers of staff with the right mix of skills, deployed effectively both during core and on-call hours.
Speaking after the publication of the report and recommendations last night, Health Minister James Reilly said that patients safety must be paramount and confirmed that the issue will be given attention in the next HSE service plan.
“This tragedy should not have happened,” he said. “The untimely death of Savita Halappanavar on 28th October last year was a shocking wake-up call to the whole healthcare system about how failures in patients’ care can sometimes have extreme consequences.”
He has outlined a five-point priority plan which includes moving towards a culture of patient safety, creating a code of conduct for employers, monitoring the progress of the 34 recommendations, developing a strategic plan for maternity services and mandating clinical guidelines for sepsis and clinical handover.
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How about some balanced coverage on all the people who died as a result of negligence in Irish Hospitals!
I can’t understand why people in maternity wards are “not equipped round the knowledge of sepsis”. Sepsis has historically been one of the two main causes of death in childbirth up to the modern era of obstetrics (the other being haemorrhage).
It’s beyond belief that any properly trained obstetrician or midwife would not be aware of the consequences of leaving a woman to labour for three days with the cervix open to any infection without doing rigorous checks for infection.
It was a tragic case. It should never have happened. It should never be allowed to happen again, … But will saturation radio coverage help ?
Anthony,
It’s not one case. It’s systemic malpractice and cover-up. HIQA is to the HSE as GSOC is to the Gardaí – pretty much toothless.
The legislators who set up these bodies should be questioned as to why what they set up does not work.
Accountability is nonexistent in Ireland. It’s time that changed.
I know. … And i agree. But i am sick and tired of hearing about it every time i turn on my radio.
That’s a worthy comment on how radio works in this country, news is micromanaged here so the public get worn down on major issues while the underlying trend just slithers by.
Hang on, are you saying the saturation coverage of this story has been a deliberate attempt to make the public stop caring about it?
The Journal has so e serious explaining to do, in that case!
Radio, Cherry. Radio.
I haven’t heard the the word Abortion mentioned, now that the Government has pushed it through, they don’t need to use this case any more, don’t let truth and fact get in the way of what you want!
have your say