Five reviews into care at Portiuncula in progress

Five reviews into the care of women and infants at Portiuncula University Hospital in Galway are still in progress and are due to be completed by next March, it has been confirmed.

Health Service Executive CEO Bernard Gloster told a Joint Committee on Health on maternity services at the hospital, that these reviews into the care of women and infants cover the period October 2024 to July this year.

He said he could not give a timescale on how long the transfer of high-risk maternity patients to Galway University Hospital will continue, but indicated it will continue for a considerable period of time.

Committee chairperson Aidan Farrelly said there was a concern that there may be a move to close PUH.

Mr Gloster said that if a unit continued to be dysfunctional that would happen, but there was no such direction and he did not see that occurring in this case.

In his opening statement, Mr Gloster said the care provided to 12 women and their infants at PUH have been reviewed or are currently under review.

Seven completed reviews have been shared with the families and overall they made 52 recommendations and progress on each is being tracked, the HSE said.

In 2023, two cases of stillbirth occurred at PUH.

Subsequent systems analysis reviews of the care provided to these two women raised concerns about aspects of their care that may have had an impact on their outcome, Mr Gloster told the committee.

During 2024, five babies were referred for therapeutic hypothermia (HIE), a rate considerably above the national rate.

HIE is where before, during or after birth, there is not enough oxygen or blood flow to the baby's brain.

Mr Gloster said that all five cases were reviewed by a team external to the West North-West Region and which produced reports.

Portiuncula serves a wide area - east Galway, Westmeath, north Tipperary, Roscommon and Offaly - and was managing around 1,300 births a year.

In January, the HSE announced an external team to manage maternity services at the hospital.

The HSE decided in July that high risk cases be managed by Galway University Hospital or another unit of a woman's choice.

Since 28 October last, PUH has no longer been taking bookings from women in higher risk categories.

Figures show that new bookings for pregnant women at the hospital for the year are down 18% compared with last year.

Mr Gloster said hat there are no significant concerns arising from safety indicators across 18 of the country's 19 maternity units.

Mr Gloster also told deputies that he wants to acknowledge the concern of people who use the Portiuncula service in 2025 and the disappointment for people in the Ballinasloe and surrounding districts, plus the disruption and confidence challenges for many fine staff.

He apologised to the women and their partners for the bad outcomes and failures and whose story has been and remain the subject of these case reviews.

A report commissioned by the HSE in 2015 and published in 2018, the Walker Report, looked at 18 perinatal events between 2008 and 2014 at Portiuncula.

Perinatal events cover the period from pregnancy to birth.

The Walker report highlighted several issues including, delays in staff escalating concerns to more senior decision makers, as well as a shortage of nurses and medical staff.

It identified a number of babies who suffered from a lack of oxygen around childbirth.

Changes at PUH were recommended but issues returned some years later and at the start of this year, the HSE announced nine external reviews into new cases between 2023-2025.