Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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11. To ask the Minister for Health the position on the second investigation into the tragic loss of baby Jamie Flynn and other cases of concern, including the loss of another newborn baby on 12 May at or following birth at the maternity unit at Cavan General Hospital; if he will provide details of the persons who have been engaged to carry out each of the investigations in train; when he expects to receive each of the reports commissioned; if he will commit to publish each report on receipt; and if he will make a statement on the matter. [20776/15]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I seek an update on the four investigations into or reviews established of the loss of newborn babies at Cavan General Hospital in the past 13 months. Who carried them out? Has the Minister intervened, or will he intervene, to ensure those entrusted with the work will give sufficiently of their time to allow for the earliest possible conclusion of their investigations or inquiries and present their findings and recommendations for the earliest possible implementation, I hope contributing to a safer service and the restoration of public confidence?

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for the question. I am conscious of the personal tragedies of the families at the centre of these sad incidents and do not want to intrude on their privacy. I offer my sincerest sympathy to the families involved who have suffered such a sad loss. As Minister for Health, I do not have access to any patient's medical records, report or medical information which is confidential and should not be discussed on the floor of the House, even if I had access to it. The HSE incident management policy is being followed and reviews of the circumstances of the cases are being undertaken.

Regarding the incident which occurred in November 2012 and referred to by the Deputy, the first clinical incident review was undertaken and completed in July 2014. However, a second clinical review was commissioned in September 2014 following a legal challenge which saw the first review quashed. A draft report from the second review team is due shortly. A second review of a case which occurred in April 2014 is also under way and a draft report is being finalised. A review of a third infant death in Cavan General Hospital in May 2014 is also under way. A fourth infant death occurred earlier this month and the process of establishing a review team in line with HSE's national incident management policy is under way and should happen forthwith. There should be no further delay.

Pending the outcome of the reviews of the incidents referred to and in view of the need to respect the privacy of the families concerned, I am not in a position to make available any further information on the investigations at this time. I have been assured that HIQA will conduct a focused programme of monitoring of compliance with the National Standards for Safer Better Healthcare across maternity services nationally. This programme will include the maternity unit at Cavan General Hospital. HIQA has commenced this work which will be completed by the end of the year.

Separately, the HSE is taking steps to commence a quality, risk and patient safety assurance review to assess the current governance arrangements in place in selected HSE-run maternity units. Cavan General Hospital and South Tipperary General Hospital are to be included in this review. If immediate patient safety concerns are identified during this review I expect them to be acted on immediately.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I join the Minister in extending my continuing sympathy to the families of the tragic babies at Cavan General Hospital. Although I do not know who has been given responsibility for the 2014 reviews, I know the four names of those entrusted with the second investigation review of the tragic loss of baby Jamie Flynn. The information has been publicised. Will the Minister tell us who is conducting the further reviews of the May tragedies and if the offer of responsibility has issued in the most recent tragic loss? I can comment on the list of those who have been asked to investigate a second time the tragic death of baby Jamie Flynn. They are eminent practitioners and professionals. My concern is the length of time it takes. They are very busy people in their respective areas of responsibility and, as a result, the time they can invest in carrying out these investigations may be limited.

Is the Minister is considering making future appointments to such positions on as near to a full-time basis as possible to ensure the speediest possible reporting, publication of findings and implementation of recommendations?

Leo Varadkar (Dublin West, Fine Gael)
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Each review team comprises a chairperson and three other members. I have the names but I am not sure whether it is appropriate to divulge the names of individuals who are participating in confidential reviews.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will the Minister furnish them to me separately?

Leo Varadkar (Dublin West, Fine Gael)
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I will have to get advice on whether it is appropriate to share the names.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister should consult as he pleases.

Leo Varadkar (Dublin West, Fine Gael)
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I will.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I cannot understand why there would be a different opinion. One is against another.

Leo Varadkar (Dublin West, Fine Gael)
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If the Minister for Justice and Equality was asked to divulge the names of jury members currently hearing a trial, I do not think that would be appropriate.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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No, it would not. There is no analogy.

Leo Varadkar (Dublin West, Fine Gael)
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Without consulting on the matter I would prefer not to provide the names of individuals participating in a review. I hope the Deputy understands why. In regard to the fourth case, the review team has not yet been established. We have been in contact with the hospital to impress on it the importance of beginning that review expeditiously.

I agree with the Deputy that individual case reviews in Cavan, Portlaoise and elsewhere are taking far too long. If we assign people to work on them on a full-time basis, that would mean moving them from front-line activities. Perhaps that is something we need to do or alternatively we should use people who have retired from clinical practice. There are consequences for other patients when people are reassigned from their front-line activities to carry out reviews.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It merits consideration, whether in terms of people who are retired or in other circumstances. We need an expeditious review and a report at the earliest opportunity so that we can act on the recommendations. That is crucial for re-establishing public confidence. It is in the interest not only of the families who have been bereaved and the wider catchment of the maternity unit in Cavan General Hospital but also of those who are first class in their roles within that hospital and who feel their abilities are being questioned by virtue of the fact these tragedies have occurred without actions or conclusions necessarily being undertaken. It is important for all concerned that the review is completed expeditiously. I again ask the Minister to ensure that will be the practice in the future.

Leo Varadkar (Dublin West, Fine Gael)
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I agree with the Deputy that it is important individual case reviews are carried out expeditiously, provided they are also done properly and thoroughly. Sometimes that can take time but the fact that they can continue for several months and, in some cases, more than a year is difficult for the patients and families concerned. They want to find out what happened and to be assured it will not happen to somebody else. That should be doable in weeks or months rather than taking six months or a year. The Deputy is correct that it casts a shadow of doubt over the clinicians who looked after the patients. That can cause stress for the clinicians even though it is found in the vast majority of cases that they did the best they could in the circumstances. The issue also arises in respect of Portlaoise. I will put in place measures to assist those involved to complete the case reviews much more quickly.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Apologies were received from Deputy Broughan who is not here to put Question No. 13. The Deputies who submitted Question No. 12 and Questions Nos. 14 to 18, inclusive, are not present.