
'Trust is broken': Committee hears of calamity and failures by CHI over children's surgery controversy
Calamity, failures in care, broken trust, and stonewalling of parents were raised during an emotional Oireachtas Health Committee with Children's Health Ireland (CHI) which left many questions unanswered.
The discussion focused on unnecessary hip surgeries at Temple Street and Cappagh hospitals, unapproved springs in spinal surgery, a toxic work culture, and delays in care identified in an unpublished report from 2021.
Only 72 out of about 1,800 children affected by the hip surgery controversy have so far been seen, CHI clinical director Ike Okefor confirmed. He expects it will meet the six-month deadline.
He apologised for how the opening review clinics were run, with one case involving a five-and-a-half-hour appointment.
Sinn Féin health spokesman David Cullinane asked specific questions about care in oncology and urology in light of the unpublished 2021 report. He asked if parents of children referred to in that document as 'Crumlin orphans' were told about the alleged sup-optimal care outlined.
Parents feel, he said, 'stonewalled, they feel they are meeting with a wall of resistance, they say they are being failed". When he was told information was not given to them, he said it is a "failure".
CHI CEO Lucy Nugent said its legal advice remains not to publish the report.
A HSE official – Kate Killeen White, regional executive officer for Dublin Midlands – said she referred concerns in that report about use of public money to gardaí. She said CHI had not considered the problems had met the threshold for garda involvement.
Senator Tom Clonan and others asked about potential risks of infertility for children waiting too long for treatment of undescended testes, as described in that unpublished report. CHI was unable to say how many were affected.
Ms Nugent said it sought advice on the potential impacts. 'They did not meet the threshold for open disclosure,' she said.
Senator Maria Byrne raised the issue of national oversight for hip dysplasia care, asking why a Health Information and Quality Authority (Hiqa) review into this last year had not led to a national universal screening programme.
HSE chief clinical officer Dr Colm Henry said Hiqa advised a more targeted screening programme, but said the HSE is 'trying to finalise a proposal' for universal screening. There is selected screening at 16 centres, he said, adding the HSE 'will certainly be making the case' for expansion to the National Screening Advisory Committee.
Questions were asked about oversight of devices in light of Hiqa's report in April on use of unapproved springs in surgeries. Former CEO Eilish Hardiman was asked to comment in light of her continuing key role in the moves to the new hospital.
'Part of the accountability is being here today and answering the questions to the best of my ability,' she said.
'I accept that there were weaknesses, and I've apologised for those particular weaknesses, we have put in structures and processes to try and address them.' These changes include improvements in procurement.
Committee chair Padraig Rice said he was not satisfied in general and particularly on the non-publishing of reports. He asked CHI to share their legal advice on the 2021 report. 'Trust is broken,' he said.
Ms Nugent and Ms Hardiman apologised to families repeatedly during heated discussions, with the new CEO pledging a new culture will take them into the national children's hospital.

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Irish Times
10 hours ago
- Irish Times
Minister in the spotlight as health controversies intensify
'It is frightening, what was happening at CHI', Sinn Féin health spokesman David Cullinane said as politician after politician at the Oireachtas health committee tore strips off the embattled group that runs children's hospital services in Dublin. The hospital group knew it would be facing a rough day given the litany of contentious issues facing it: the implantation of unauthorised springs , allegations surrounding unnecessary hip operations , controversy over lengthy waiting lists for spinal surgery, an internal report identifying dysfunctional behaviour and a toxic culture in parts of CHI as well as concerns over whether National Treatment Purchase Fund (NTPF) money earmarked for reducing hospital waiting lists had been misused. As CHI was heading to the bear pit that is the committee room on Thursday, Minister for Health Jennifer Carroll MacNeill was on her way to a European health council meeting in Luxembourg. 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There is a clear sense within Government that the aggregate effect of the series of controversies represents an important moment and a shift in gears for Carroll MacNeill's ministerial career. 'It is a huge test for her, a huge challenge,' one source said, adding there were nascent concerns about keeping the centre of Government informed as the controversies develop. 'While she is the line minister, she is responsible, from a public perception point of view, the Government is responsible.' She must also master the inner workings and unpredictable dynamics of a health crisis – something that eventually falls to everyone in her position. This is particularly the case for one that is, in fact, composed of several overlapping sub-crises – a 'sprawling controversy with so many elements', as one source described it. She must keep track of timelines, keep the information flow running, keep across who knew what and when. For a first-time Cabinet minister, it is the ultimate acid test. Some of this may just be timing. The report by the health services watchdog, the Health Information and Quality Authority (Hiqa) on the unauthorised springs was always set for May and Government knew this would probably cause a storm that would be quickly followed by an equally damaging analysis into operations for children with developmental dysplasia of the hip. However, the stunning leak of an internal CHI report identifying potential patient safety risks, questionable use of NTPF-funded waiting list clinics and a toxic culture at one CHI hospital came out of left field. Ministers and health chiefs said they had been blindsided. The revelations also highlighted divisions between different parts of the health system and put the spotlight on flaws in the governance structures. Last week the NTPF confirmed it had suspended funding for waiting list initiatives at another centre, Beaumont Hospital in Dublin, on foot of potential financial irregularities. The Irish Times revealed this followed a letter sent to the chairwoman of Beaumont by consultants in which they maintained the hospital had billed the NTPF for about 1,400 patients treated in their regular public clinic. The Department of Health – and presumably the Minister – had been aware of this development since April. Carroll MacNeill had directed the HSE to send internal auditors into Beaumont . However, the public was not told until June 11th. Some highly placed sources maintain all this has led to concerns about the information flow around Government. One Minister told The Irish Times there had been discussions about what was coming out. 'As we hear things, things are being circulated,' they said. 'There is no concern about the political messaging, but there is huge concern about what we hear is going on – everything, from what you hear about [HSE chief] Bernard Gloster bringing in the gardaí to everything that is going on in terms of governance, the whole shooting match. But the primary concern is about the children.' Another Government figure said there is real concern that health may blow up (politically) in a way that it has not done in five years and that there may be too much of a hands-off approach by the Minister. The Government is only too aware there is more drama to come. CHI, the HSE and the NTPF will be before the Dáil Public Accounts Committee in early July. An external review into paediatric orthopaedic surgery being carried out for the HSE is also still awaited. A separate HSE report on 'insourcing', where some staff formed private companies to carry out additional work outside regular hours to tackle waiting lists, is also due, as are the findings of the internal auditors sent into Beaumont. Governments have spent more than €1.6 billion on waiting lists over recent years, using the NTPF, the HSE 'insourcing' and other arrangements. Any questionable findings will undoubtedly lead to more allegations about waste. Carroll MacNeill is facing a balancing act of trying to deal with serious issues in CHI at a time when the organisation should, ideally, be concentrating on moving the three existing paediatric centres in Dublin into the new €2.4 billion national children's hospital. TDs, like Daly, may have no confidence in CHI. But in the meantime services for children have to continue and workforce planning and other arrangements for the move have to be carried out in parallel. In late May the Minister told the Dáil: 'I am trying to look at this question in relation to the broader governance of CHI in a way that enables the functional continuity of CHI, both to respond to the various patient needs and ... the broader running of the paediatric system and to move us towards opening the new hospital. I want to ensure we see the appropriate governance structure in place to make sure that we have clinical leads who are managing each team.' 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A number of sources have voiced concerns that the health service and CHI could replicate the rolling controversy seen over the RTÉ payments scandal two summers ago. The gaps and governance flaws identified by the CHI controversy also leaves the Minister with a decision on whether further reforms are needed. Health economist at UCC Dr Brian Turner described the current system as a complex mix of public and private funding and delivery with a large degree of overlap. He said there were publicly-funded public hospitals (run by the HSE), publicly-funded voluntary hospitals (run by their own boards) and public patients in private facilities such as nursing homes. In addition, the NTPF buys treatment in both the public and private systems. On top of this HSE reforms introduced last year led to new regional chief executives appointed to oversee services in geographic areas that covered both public and voluntary hospitals. 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One senior figure pointed to a row last year when former minister for health Stephen Donnelly wanted all hospitals to adopt a new system that would provide greater visibility over productivity. A number of voluntary hospitals objected until the minster threatened to withhold capital funding. CHI reported to the minister, not to the HSE. However, when Donnelly wanted a new chief executive appointed as the former chief executive Eilish Hardiman had served the maximum two terms under Government policy, the CHI board disagreed. Simon Harris , as minister for health in 2017 established a review of the role of voluntary organisations in the operation of the health sector. But many key structures remained in place. One senior health source said voluntary hospitals previously argued they provided a set level of services for the State under an agreement each year but were subsequently free to treat fee-paying patients and do other work. However, private practice in public hospitals is now to be eliminated over time under Sláintecare , the long-term plan to achieve universal, single-tier health and social care. One experienced health figure said it was widely known that the governance arrangements were flawed. However, he questioned whether the Government had the bandwidth or determination to deal with the aggravation that would flow from trying to change the current model of care – a process that could take several years, and possibly beyond the next general election.


Irish Times
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- Irish Times
HSE aims to bring in new weekend work rosters for healthcare staff over summer
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Irish Daily Mirror
19 hours ago
- Irish Daily Mirror
Inspector who cleared nursing home with abuse allegations worked on same campus
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