The Health Service Executive has confirmed that an investigation is under way in Cavan General Hospital following the death of a newborn baby at the hospital yesterday.

Minister for Health Leo Varadkar said it appeared the baby had died during a caesarean section, which he said was an uncommon event.

He said an individualised investigation was required, but he said he did not feel that an inquiry by the Health Information and Quality Authority was warranted.

The HSE has expressed its sympathy to the family and said a full review of the circumstances surrounding the tragedy would be undertaken.

There have been a number of incidents over the last number of years at the hospital, which have created some concern.

Last year, following the deaths of three babies within an 18-month period the then minister for health James Reilly expressed concern in a letter to Health Information and Quality Authority.

It is believed that up until yesterday six incidents were being investigated by experts from outside the hospital.

HIQA seeks review of maternity strategy

HIQA has reiterated calls for an urgent maternity strategy following the death at Cavan hospital.

Representatives were before the Oireachtas Health Committee this afternoon in relation to its investigation into the deaths of babies at the Midland General Hospital Portlaoise.

However, two committee members asked HIQA about the news that an infant had died at Cavan General.

Fine Gael TD Regina Doherty and Sinn Féin's Health Spokesperson Caoimhghín Ó Caoláin asked if HIQA had been asked to monitor the maternity unit in Cavan in January last year.

HIQA's chief executive said in line with the terms of reference for the Portlaoise investigation, HIQA committed to making an assessment of Cavan General Hospital, in the context of a review of all 19 maternity hospitals.

Phelim Quinn said in May 2014 there was communication between the minister and HIQA, with a request for the authority to conduct a review of Cavan in light of three infant deaths at that stage.

His colleague Mary Dunnion, Director of Regulation, said a maternity strategy was a critically important component in terms of a full assessment against national standards for safer and better healthcare.

She said HIQA had taken 2014 findings in Cavan and used some of those findings in its investigation in Portlaoise.

Ms Dunnion added that full findings in relation to what should be in place regarding maternity services will be completed and published at the latter end of this year.

Cavan death raised in the Dáil

Mr Kenny and Fianna Fáil leader Micheál Martin sympathised with the family during Leaders' Questions.

Mr Martin said Mr Reilly had ordered a review of previous deaths at Cavan hospital, but he said no formal order was made to HIQA and no review was carried out. He asked why this was the case.

Mr Martin said HIQA's recommendation had raised the need for a review of maternity care.

Mr Kenny said he did not want to comment further on it until the facts become known, saying that the HSE was now investigating.

However, he said this is the fourth baby to die in Cavan in the last number of years, adding that it was clearly a very traumatic situation.

He said a report by HIQA on Portlaoise hospital had implications for other maternity services in the country.

Mr Kenny said that following the previous Cavan deaths, Mr Reilly had written to HIQA asking them to prioritise the monitoring of the unit in Cavan.

HIQA subsequently sought a detailed report on the three cases and this was provided by the HSE, he said.

He said HIQA had now started focused monitoring across the maternity services nationally.

This work had already started and would be completed by the end of the year, he said.

The Taoiseach said Minister Varadkar had also begun a cross sectoral programme to reform the 19 maternity centres across the country.

INMO airs concerns over theatre staffing in Cavan

The Irish Nurses and Midwives Organisation said today it has grave concerns regarding the staffing of a second theatre at the hospital.

Speaking on RTÉ's News at One, INMO Industrial Relations Officer Tony Fitzpatrick, who has responsibility for Cavan General Hospital, said the organisation had raised concerns on this issue with the HSE over a number of years.

Mr Fitzpatrick said on four occasions in the last month there were not enough staff to ensure the safe opening of the second theatre.

"The minimum basic requirement for safety and quality care in an operating room is that you have three qualified theatre nurses when a patient is undergoing anesthesia and surgery," said Mr Fitzpatrick.

"But as it is occurring now in Cavan there is not a protocol or a system in place to ensure a second theatre when it’s required – as has occurred on four occasions in the past month, as has occurred in the past and has been part of previous obstetric reviews.

"That situation has not been addressed in Cavan."

He said that obstetric doctors in Cavan believe cases have been negatively affected by delays in trying to find staff to man the second theatre.

Mr Fitzpatrick said frequently operations proceed but the nursing team is spilt leaving only one or two staff members instead of three in a theatre at a time.

He said the HSE had said it shared the INMO's concern and it was a priority issue for them. However, he said the risk still exists and management had not responded in a timely way to the situation.

Consultant Pediatrician at the hospital Dr Alan Finan said there was no question yesterday of a difficulty with availability of a theatre or staff.

Speaking to RTÉ's News At One, Dr Finan said the issue over the availability of a second theatre was raised in relation to one case at the hospital oyer the last 13/14 months and it is being addressed.

He added the issue relates to midwifery and anaesthetic staffing of a second theatre when it is needed.

This occurs three to four times a year, and Dr Finan said it is an issue hospital management are dealing with.

Dr Finan said a number of measures have been taken in relation to midwifery staffing, which has been improved significantly, while the anaesthetic staffing issue is being dealt with as we speak.

Dr Finan also said rates of perinatal mortality at the hospital, compiled by the National Perinatal Epidemiology Centre, have been lower than the national average. 

Dr Finan said national perinatal mortality rate across all 19 maternity units over the past four to five years has to the order of four to five deaths per thousand births.

The figures for Cavan General Hospital for the three-year period from 2011-13 have been 1.5, 3.1 and 3.1 respectively.

Dr Finan said the fact that these figures are below the national average is of significant reassurance to staff at the hospital and he hoped it would be reassuring to the public also.