Concerns over the continued downgrading of services at Portiuncula University Hospital (PUH ) resurfaced sharply at last week’s meeting of Ballinasloe Municipal District, with councillors expressing frustration at a lack of transparency, accountability, and clear evidence underpinning decisions that have already led to the scaling back of maternity services.
The debate follows months of controversy surrounding the hospital, which has seen birth services curtailed despite multiple reports, including the Walker and Coulter-Smith reviews, stopping short of recommending a downgrade. State maternity safety data published late last year also failed to establish any credible case that Portiuncula was less safe than comparable units elsewhere.
Airing her concerns regarding the downgrade, independent councillor and GP Cllr Dr Evelyn Parsons described the situation as part of a wider erosion of rural health infrastructure.
“Regarding PUH, we need everyone to pull together to ensure our services are maintained. There is a downgrade happening in clear view without any enquiry.”
She argued that the issue extended beyond Galway and the west.
“This is part of the rural access issue, not even a regional issue; this is a national issue. It affects our area, and we should all work together to make sure our response from our government is the right one, that the resources are put in and that the Walker Report is implemented fully. People should be brought to task to ensure it has been upheld.”
Fine Gael councillor Alan Harney said there was cross-party consensus on the need to see services restored, but stressed that safety had to remain central.
Decision to downgrade
“We want to see that service restored, but it needs to be safe. We’re all on the same page, and I know our Oireachtas colleagues are too,” he said.
However, Sinn Féin councillor Dermot Connolly questioned who was ultimately responsible for the downgrade, pointing to conflicting statements made at an Oireachtas committee.
“The sad fact about that Oireachtas meeting is that the Minister said she made the decision to downgrade birth services, but (former head of the HSE ) Bernard Gloster said he was the one who decided – so which is it?” he asked.
Cllr Dr Parsons said she had repeatedly sought clarity on that point.
“I have asked that question time and time again. It’s hard to get an answer. The decision to downgrade appears to be a clinical direction,” she said.
Cllr Dermot Connolly insisted political leadership was required.
“The Minister needs to step up. PUH has been thrown under the bus with this. We need to see action and less talking.”
“Burying their heads in the sand”
A contrasting view was offered by Fianna Fáil councillor Michael Connolly, who said responsibility lay largely with hospital management.
“There had been persistent systemic behaviours in Portiuncula, that is a fact. The Oireachtas committee proved things weren’t right,” he said.
He noted that while a key clinician did not attend the committee, former HSE CEO Bernard Gloster had.
“He did give his commitment to try to resolve this, and thankfully, they seem to be working together on it. There had been problems at PUH, and there are ongoing clinical issues. The people who made that call left the Minister with no choice but to close certain services. Those things have to be put right.”
Cllr Connolly said it was “important that we recognise there is a problem” and urged people to “stop burying their heads in the sand” about maternity care at the hospital.
Cllr Dr Parsons strongly disagreed, stating that no report had recommended a downgrade.
“There was no recommendation for a downgrade of services in any report regarding this issue. The Walker Report didn’t recommend a downgrade, nor did the Coulter-Smith report,” she said.
“What we are looking for is clear evidence that has not been provided. There is no comparative data between maternity units, no report stating Portiuncula is unsafe compared to any other unit. There are issues arising in other units, too.”
She said there had been no commitment from the HSE to reverse the downgrade or provide a timeline.
“That is very concerning. What we are looking for is an independent external review away from the system that has been charged with improving it and is now dismantling it. You can’t have the HSE deciding on the HSE’s direction.”
Reputational damage
Cllr Dr Parsons said the reputational damage was significant.
“There has been huge reputational damage with women using PUH. They now have to travel much further to receive care. We are seeking transparency that has not been provided.”
She added that none of the Walker Report recommendations had been implemented.
“We need to know whether the same thing would have happened if they had been implemented.”
Speaking both as a doctor and an elected representative, she said she and her municipal district colleagues were “all upset about the Portiuncula downgrade”.
“The decision to move services away from the women who need them is unacceptable. I do sympathise with the families at the root of this discussion. But I am scientific by nature and evidence-led. I need to see the evidence. Based on what we’ve been given, we cannot say for certain what is going on.”
In response, Cllr Michael Connolly said he accepted there were communications failures, but said the HSE had stated “there is no intent to close the maternity unit”.
“The downgrades are to get the unit in line with current standards,” he said, adding that the advice in reports had not been implemented.
“And who is at fault for that?” asked Cllr Dr Parsons.
“The hospital management and the HSE,” Cllr Connolly replied, a response which Cllr Dr Parsons said relieved the Minister and Government of responsibility.
Beyond political affiliations
Seeking to refocus the debate, Cllr Harney said the situation “raises huge questions” but urged councillors to concentrate on restoring services.
“It is important that we focus on getting the service restored. When the Minister was on Galway Bay FM recently, it is only now that the HSE is saying the same. On a regional basis, this raises huge questions.”
He also pointed to positive developments, noting that planning permission has been granted for a €12 million extension to the hospital’s A&E department.
Independent Ireland councillor Declan Geraghty called for unity.
“Let’s take off our political affiliations. We are councillors for this area, and we’re talking about a fine hospital up the road, a fabulous facility,” he said.
“The HSE had no right to close down PUH when the recommendations in the Walker Report were not implemented.”
Cllr Peter Keaveney (FG ) echoed the sentiment.
“Everyone in this room wants to see services reinstated at PUH. The hospital is accessible to a lot of women, and there are a lot of questions to be asked.”
