The HSE’s decision to reduce the scope of maternity services at Portiuncula University Hospital (PUH ), has prompted united condemnation from Galway County councillors, resulting in calls for Government intervention.
The issue was discussed at Monday’s July Plenary Meeting of Galway County Council, nearly two weeks after the HSE announced the transfers on July 10. A motion submitted by Ballinasloe councillor and GP, Dr Evelyn Parsons, received unanimous cross-party support.
“Once a service is stripped back, it undermines the long-term viability of the unit, and this is a process that usually leads to a downward spiral of reduced resources, diminished confidence, falling patient numbers, a loss of training accreditation and eventually closure. There is also an erosion of staff confidence and user trust,” said Cllr Parsons.
“There are growing concerns that these decisions are being made within an opaque governance structure which lacks external challenge and accountability, and we must call for accountability and transparency and the objective basis underpinning decisions which impact the communities we represent. The safe care of mothers and babies must remain a paramount consideration in all decisions in our health services.”
High-risk pregnancies
The HSE announced on July 10 that maternity services at PUH would be downgraded, with 200 to 300 expectant mothers with high-risk pregnancies to be transferred to Galway University Hospital (GUH ) or a hospital of their choice. This followed ongoing investigations into PUH’s maternity care standards, five of which have been completed, with seven more currently under way or due to begin shortly.
There have been a total of 35 maternity cases investigated in the hospital since 2008, several of which involved babies with hypoxic-ischemic encephalopathy (HIE ), a condition caused by reduced blood flow to the brain at birth. One such investigation, the 2018 Walker Report, flagged a number of key issues with PUH’s maternity services. Despite changes following the Walker Report, the HSE says recent reviews have identified similar issues, “prompting preventative action for high-risk expectant mothers”.
As a result, PUH has broadened its definition of a high-risk pregnancy to include expectant mothers who have larger BMIs, alongside a broader group of women.
As a result, the estimated 1,400 annual births at PUH are expected to fall by 300 to 400 once the changes are fully implemented over the coming months.
The motion
“Maternity services at Portiuncula are extremely important, one of the most important issues for us as Ballinasloe councillors. Our constituents are hugely worried about the removal of services from the hospital. We consider this situation to be the beginning of the wedge which could lead to the downgrading of PUH and the removal of services,” said Cllr Dermot Connolly (SF ).
“As a singular voice, we can call for answers and support PUH and its services for its patients and the mothers involved.”
To formalise this united stance, Cllr Parsons proposed a motion calling on Galway County Council to “reaffirm its strong support” for PUH and urge the Minister for Health and the HSE CEO to reinstate maternity services at the hospital. Her motion also called for a full external review of maternity services nationwide, examining risk assessments and the consequences of downgrading care.
The motion passed unanimously.
“My voters may be very concerned by the statements that have come out from the HSE in recent weeks. In particular, we know that 34 actions have been recommended by the five reviews that have been completed. However, there is very little that is new in these recommendations,” said Ballinasloe Cllr Alan Harney (FG ). “I think particularly the decision to move higher-risk births to other maternity units is very questionable, particularly when we know that quite a number of the women affected were not in the high-risk category and, going by this criteria, would still have given birth in PUH. It has raised a question whether this decision has been taken on the foot of reviews, but the decisions the HSE have taken would not have alleviated the risks which existed in the first instance.”
“I think it is really short-sighted, what we are seeing here is a reduction of maternity services, because no doubt what has been identified in PUH is not unique and is what women face around the country,” said Cllr James Charity (FG ).
Accountability
Cllr Geraldine Donohoe (Ind ) questioned the timing of the announcement and who signed off on the decision.
“If there is anything this chamber can do to prevent this action, we have to do it,” she said. “Every pregnancy comes with risk; it can change in seconds. You can have the best birthing plan in place, and it can just go upside down in seconds. Can we get some accountability on who signed off on this?
“You know what is sneaky about this - it happened while the Dáil is in recess and we cannot debate it. It is disgusting.”
Cllr Parsons also questioned the timing, describing it as disingenuous, and highlighted that recommendations from a 2018 review were never implemented.
“A point was made about accountability and transparency,” she said. “Some of the recommendations from 2018 were not put in place. Why were they not put in place?
“By the way, of all the reports that have been completed, none have recommended closure. So where has this decision to downgrade come from?”
“Let us stand united for our hospital, for our county and all the other surrounding counties and get involved in this fight to save PUH,” said Cllr Declan Geraghty (Ind ).
“I think we need to meet the Minister. This cannot be allowed to happen, PUH has been a vital point for maternity services in Galway and the surrounding counties. We are all behind this, and we are asking the Minister to do what it takes to keep PUH going,” said Cllr Peter Keaveney (FG ).
“We are going to fight this tooth and nail.”
