One in Eight Irish Maternities Involved a "Clinical Incident"

06.03.2017

The Health Service Executive has revealed that 7,247 clinical incidents were recorded last year involving approximately 12.6 per cent of all women who gave birth in maternity hospitals. A “clinical incident” is an event that could have resulted, or did result, in unnecessary harm to a patient. The highest rate was at the National Maternity Hospital in Holles Street, Dublin, where a clinical incident in the case of more than one in four mothers, while the lowest rate was in Letterkenny University Hospital at just under 5 per cent.

The Rotunda Hospital in Dublin has refused to publish the figures for the 8,400 women who gave birth in the hospital last year. A spokeswoman said it did not believe that the number of clinical incidents recorded in the hospital was “any indicator of safety”. “Additionally,” she said, “there is currently no agreement among hospitals nationally as to which events require filing a clinical incident report.” The Rotunda claimed its reports were “maternity activity statements and not a patient safety report”.

The masters of Dublin’s main maternity hospitals—the three largest in the country—voiced strong objections in 2015 to the HSE’s decision to make hospitals publish such information. The heads of the National Maternity Hospital, the Coombe Women & Infants University Hospital and the Rotunda Hospital claimed the monthly statements would leave institutions at risk of “adverse publicity and media scrutiny”. They were also concerned that their hospitals as tertiary-referral centres would have higher rates of stillbirth and perinatal deaths as they received more complex cases involving babies with higher rates of congenital anomaly, prematurity and other complications. The obstetricians warned that a knock-on effect of such scrutiny could be the under-reporting of some negative outcomes.

The HSE said the information was published to provide public assurance that maternity services were delivered in “an environment that promotes open disclosure”. Publication of such statements was recommended in two reports published by the HSE in 2014 and the Health Information and Quality Authority in 2015 into the high rate of perinatal deaths at the Midland Regional Hospital in Portlaoise between 2006 and 2014.

The percentages of mothers who were induced and given caesarean sections continued the recent upward trend again last year. The highest rate of induction was in Our Lady of Lourdes Hospital in Drogheda at 39.3 per cent of mothers compared with the national average of about 32 per cent. The lowest rate was in St Luke’s at just over 17 per cent. Almost one in three women who gave birth last year delivered by caesarean section, with the highest rate of 40 per cent recorded in St Luke’s. The lowest was 24.6 per cent in University Hospital Waterford. The national average was 32.5 per cent, up from 30.9 per cent in 2015.

A report by the Economic and Social Research Institute last October claimed the rising proportion of women having their babies delivered by caesarean section was placing an increased risk on their health. It noted that the share of babies delivered by caesarean section had more than quadrupled over the past 30 years.

The Times. March 6.