Minister and HSE chief contradict each other on Portiuncula report
In recent appearances at the Oireachtas, the chief executive of the HSE, Bernard Gloster, and the Minister for Health, Jennifer Carroll MacNeill, contradicted each other on whether a 2018 report into maternity services at Portiuncula hospital had been fully implemented.
Their contrasting answers were given in response to questions from Roscommon-Galway Fianna Fáil TD Dr Martin Daly in relation to the decision earlier this year to transfer all high-risk pregnancies from Ballinasloe to other hospitals.
In 2018, an independent external review chaired by Professor James Walker published its report into eighteen cases involving patient care at Portiuncula's maternity unit between 2008 and 2014.
When the CEO of the HSE, Mr Gloster, appeared before the Oireachtas Joint Committee on Health last month he told Deputy Daly that the Walker Report's recommendations from 2018 had not been fully implemented.
"I think the Deputy has clearly pointed to deficits between what the report said and what subsequent incidents recorded as having happened," said Mr Gloster.
At a later point in the discussion, he added: "To be clear, it would not be reconcilable for me for someone to say the Walker report was fully implemented."
However, in the Dáil on Thursday last, October 2, Health Minister Jennifer Carroll MacNeill gave a different answer about the implementation of the 2018 report.
"The Walker report came from a review commissioned by the then Saolta Group in 2014 following a number of serious maternity cases at Portiuncula maternity services from 2004 to 2014.
"It covered 18 cases and was published in 2018, making 154 recommendations," said the Minister.
"The HSE has advised my Department that all 154 recommendations were independently verified as implemented by both HIQA and an independent national HSE team. HIQA has verified that."
Minister Carroll McNeill said one of the recommendations was to have a single clinical director covering Portiuncula hospital and University Hospital Galway.
She said this was implemented between 2021 and 2024, but "gaps in governance" had then emerged and it was decided to revert to having a clinical director on both sites from August 2024.
"All 154 recommendations were implemented and that is one which just did not work and the HSE reverted to having two clinical directors as opposed to one overseeing the complete group," said the Minister.
Commenting to the differing version of events given by the top official in the HSE and the Minister for Health, Deputy Martin Daly said it undermined confidence in the leadership of the health service.
"This contradiction is deeply concerning," the TD said.
"On one hand, the Minister cites assurances from HIQA and the HSE that the recommendations were actioned. On the other, the HSE's own chief executive has openly admitted that they were not.
"These two accounts cannot both be true. It raises fundamental questions of confidence — not in the clinical staff on the ground, who provide excellent care every day — but in the senior clinical management structures and in HIQA as an independent regulator.
"If HIQA's analysis is at odds with the HSE CEO's own account, how can the public have trust in the system?"
The lead story in last Friday's Galway City Tribune, meanwhile, referred to concerns over the impact of an "influx" of new patients to the maternity unit at University Hospital Galway due to Portiuncula no longer accommodating high-risk cases.
The paper said the HSE's regional executive officer Tony Canavan told a meeting of Regional Health Forum West that the decision to transfer all high-risk pregnancies from Portiuncula was made necessary by "a significant number of adverse clinical outcomes" between late 2023 and the second quarter of 2025.
Mr Canavan also confirmed there were no current plans to reinstate full maternity services at Portiuncula.
"We're not planning the reinstatement at this time," he said. "That's not me saying it could never happen, but what I'm saying is is our focus is on making sure that we deliver safe care today and that we take appropriate steps today to deliver safe care."