Concerns over future of Portiuncula maternity services
Concerns have been raised over the future of maternity services at Portiuncula University Hospital in Ballinasloe following a decision to transfer the care of high-risk pregnancies elsewhere.
The move by the HSE, on foot of five external reviews into the care provided to women and their babies at the hospital, has sparked fears that maternity services at the hospital, used by many women from South and West Offaly, are being downgraded.
It's understood up to 300 expectant mothers a year could now be cared for elsewhere, representing more than 20% of the annual number of births at the hospital.
READ: Summary of external reports
This has prompted a strong political reaction, with Sinn Féin Roscommon Galway TD Claire Kerrane calling on the Minister for Health to instruct the HSE to “prepare and publish an urgent roadmap to the full restoration of maternity services” at Portiuncula.
Independent Ireland also warned against any downgrading of maternity services at Portiuncula University Hospital, saying proposed changes would leave some mothers from local communities exposed and unsupported.
The party's Roscommon Galway TD Michael Fitzmaurice said the plan amounted to “a slow dismantling of core maternity services under the guise of reform."
“The reality is this — maternity services in Portiuncula are being quietly gutted,” he said.
“This is a hospital that has served this region for generations. Obviously, there have been tragedies in the past and safety of the mother and baby is the paramount consideration. But you don’t solve past failings by moving care out of reach for future families. What’s needed is investment, not retreat.”
Since a previous report into maternity services at the hospital in 2018, some high-risk pregnancies are already being transferred to Galway University Hospital (GUH).
The HSE said this would now be expanded to other groups of higher-risk women whose care will be transferred to GUH or the hospital of their choice, in the coming months.
These could include those with a previous loss of a baby, history of significant medical disease, history of massive obstetric haemorrhage, obesity and maternal age. Women considered likely to deliver their baby before 35 weeks pregnancy will also have their care moved.
The HSE action came following the completion of the first five external reports, with a further seven underway or due to commence.
Last January, external experts were appointed to oversee maternity services at the hospital and the HSE announced individual external reviews were underway into the maternity care provided to nine women who gave birth there since late 2023.
It said, since the start of 2024, seven babies were born with hypoxic ischaemic encephalopathy (HIE) (the reduction in the supply of blood or oxygen to a baby’s brain before, during, or after birth).
Six of those babies were referred for neonatal hypothermic treatment, also referred to as neonatal cooling.
At the time, the HSE said the incidence of HIE, resulting in referral for neonatal cooling treatment, was “significantly higher than that observed nationally or internationally for a similar time frame.”
Reviews were also taking place into the care provided in the cases of two stillbirths which occurred at the hospital in 2023.
A further three births, since January of this year, are now also subject to the review process.
The HSE said the five external review reports had been shared with the families and it would now offer to meet individually with them to discuss the findings, answer any questions and lay out the next steps.
The HSE said work on implementing the recommendations of the five reviews was already well advanced.
It said the external team now in charge had made “significant improvements in clinical governance, operational processes, patient care pathways, and multidisciplinary team collaboration.”
An implementation team with key stakeholders is now being set up to further progress the recommendations and any further changes required over the coming months.