Dáil Éireann Debate, Tuesday - 19 May 2015
368. Deputy Robert Troy asked the Minister for Health if he will initiate an independent review of the latest reports of stillbirths following information received from a freedom of information request; and if he will make a statement on the matter. [19674/15]
View answerWhile I would welcome the publication of perinatal data by hospital, it must be pointed out that perinatal mortality statistics are complex. Reporting on these rates has been hampered by different definitions of stillbirth both nationally and internationally. In Ireland, four difference agencies are involved in the compilation and reporting of perinatal mortality data. The analysis presented in the Report of the Chief Medical Officer into Perinatal Deaths in Portlaoise Hospital (February 2014) showed that there are weaknesses and inconsistencies in perinatal data collection, collation and reporting.
Perinatal death is a rare event in Ireland. Given the small numbers involved the use of perinatal mortality rates by hospital as an indicator of patient safety creates a risk of false reassurance and also can raise false alerts. It is, therefore, important to look at these in conjunction with, for example, confidence intervals per hospital and other methods in order to distinguish between the stability of estimates based on small versus large numbers. Therefore, caution needs to be exercised in the interpretation of perinatal data by hospital for the reasons set out.
A number of actions are being taken to address these discrepancies as follows:
- The notification of stillbirths is a mandatory requirement in the Civil Registration Act (2004). This Act was amended in 2014 to make notification of early neonatal deaths mandatory. The General Registration Office is working on the commencement of this.
- In addition the HSE has agreed to progress agreement of definitions and reporting of perinatal statistics in Ireland. This would include systems such as the National Perinatal Reporting System and the National Perinatal Epidemiological Centre.
It should be noted, however, that national statistics on perinatal events are very important in benchmarking with other countries. Irish national perinatal data compare favourably with other OECD Member States which provides a level of reassurance on the quality of maternity services in Ireland.
National perinatal mortality data in respect of 2014 are still being collated and validated and it is not clear at this stage when these data will be ready for publication.
Patient Safety oversight in hospitals must take into account broader activity trends which can provide early warning of safety risks and early identification of safety issues. The Chief Medical Officer's Report identified the need to develop a more accurate and timely alert system. The Chief Medical Officer recommended that all maternity hospitals should develop a Patient Safety Statement which would be published and updated monthly and would be used with other available information to risk-rate services and to target quality improvement measures that enhance local ownership and capability. Ideally a Patient Safety Statement should be presented and discussed at the senior management team meetings every month, as a standing agenda item.
This should set out trends in relation to activity, interventions, complaints, adverse incidents, serious incidents, transfers, staffing and any other appropriate information from the perspective of patient safety and quality. This should be part of an on-going quality improvement cycle. The Health Service Executive is progressing the CMO's recommendation.
I would like to assure the Deputy that work in on-going to improve the data sources and the quality and safety of maternity units nationally.
