The health watchdog is to investigate the patient safety culture at Portlaoise Hospital and examine whether the HSE governance structure is supporting services at the hospital or not.

HIQA has published the terms of reference of its investigation into the Midlands Regional Hospital after the deaths of five babies since 2007.

The probe will:

• assess the patient safety culture in the Hospital
• investigate and assess how local, regional and national clinical and corporate governance arrangements provided by the HSE are supporting the safety and quality of services at the Hospital for general and maternity patients, identifying whether risks to patients in the Hospital's models of service provision have been identified, assessed and mitigated
• investigate what measures have been taken by the Hospital and the HSE in the implementation of national recommendations from previous investigations and reports

HIQA says if there are grounds to believe there are further or other serious risks to the health of anyone receiving the services, the investigation team may recommend these terms be extended to include "further investigation or that a new investigation should be undertaken".

The investigation will be carried out under the provisions of the Health Act 2007.

A report by the Department of Health found that the maternity service at the hospital was not safe or sustainable and an interim management team was put in place.

Stephen McMahon from the Irish Patients Association says it is a huge step forward that the HSE structure, as well as hospital staff, are under scrutiny.