Eternal vigilance is the price of quality

Denis Doherty examines how we should learn from the harrowing events in Portlaoise.

Denis Doherty
Denis Doherty

The HIQA report on the Midland Regional Hospital at Portlaoise is a harrowing read. The HSE owes it to the mothers and families who were failed by the hospital to implement the recommendations in the report fully and speedily.

Those who failed in their duty of care failed their patients, themselves, their colleagues and the healthcare service. They know who they are.

Those who didn’t stop caring know who they are. The patients they care for know who they are. They are normal caring people, doing their personal and professional best, who are feeling the hurt that stems from unrelenting criticism of their place of employment. They are owed a duty of care.

For over twenty-five years, up to ten years ago, I knew the hospital in Portlaoise well. It was typical of hospitals of its type. Staff provided the best service they could and constantly strove to improve the service they offered. In the nineteen eighties, the first Obstetrician Gynecologist at the hospital, Dr. Jack Conway, produced an annual clinical report which was unusual in Ireland at that time.

Those who failed in their duty of care failed their patients, themselves, their colleagues and the healthcare service

There is a lot of public service employment in Portlaoise; in the hospital, the mental health service, the prison and the Gardaí. Many public servants are active in community and voluntary organisations in Portlaoise and the surrounding areas.

Time was when employment in the caring professions bestowed a badge of honour that recognised the demanding work involved. Now, many feel they have to earn the respect of those they care for every day they go to work.

A persistently negative environment can be corrosive and affect even the most vocationally committed professionals. They don’t become inured to calls for the hospital to be closed or threats that services might be discontinued or a sense that the good they are doing is going unrecognised.

One of the lessons we have learned from the Portlaoise experience is that, like democracy, the price of quality in a hospital is eternal vigilance. Portlaoise came up short and is paying the cost.

The people of Laois and many in surrounding counties in Offaly, Carlow and Kildare rely on the hospital in Portlaoise for essential health services. They are entitled to want to be assured that the services they are being offered are of a high standard and do not involve risks any greater than in other similar hospitals.

At a time of crisis staff on the ground require a lot of support to enable them to continue doing their jobs well. It is not apparent that hospital staff members in Portlaoise are receiving the level of support they would benefit from. If there has been any acknowledgement of the good being done by many staff on the ground in Portlaoise, day in and day out, I have missed it. The corrosive effect of a negative environment affects morale, self confidence, decision-making and can lead to mistakes.

High standards at the hospital in Portlaoise, in the short and medium terms, will rely heavily on the contributions of the existing committed and caring staff there. They are capable of delivering what is required provided they are supported, developed, encouraged, empowered and valued.

We all respond better to praise than we do to criticism. It would be a great pity if, in dealing with failures of the past, we fail to harness the potential for improvement in Portlaoise that exists there at present.