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Irish Times
2 days ago
- Health
- Irish Times
CHI hearing: Some children who had hip surgery may not have reviews until next year, committee told
Some children who underwent surgery for developmental dysplasia for the hip (DDH) at two Dublin hospitals may not be seen for a review of their care until next year, a senior Health Service Executive (HSE) official has said. Developmental dysplasia of the hip is a condition where the ball and socket joint of the hips does not properly form in babies and young children. On Thursday, the Oireachtas health committee heard from Children's Health Ireland (CHI) and the HSE in relation to a number of issues that have emerged at the paediatric healthcare provider in recent months. In recent months, there has been a review into the use of unauthorised springs in three children with scoliosis , an audit on the threshold for hip surgery and a leaked internal report on 'toxic' work culture and potential misuse of State funding to tackle waiting lists. READ MORE A random audit of 147 children who had hip dysplasia surgeries across Temple Street, Crumlin and Cappagh hospitals between 2021 and 2023 was published in recent weeks. It found 60 per cent of these procedures at Temple Street hospital did not meet the clinical criteria for surgery, with the figure being 79 per cent in Cappagh hospital, raising concerns about the necessity of the surgeries. Following the audit's publication, the HSE announced there would be an external review panel to allow all families whose children received surgery since 2010 – some 2,200 children – to obtain a second opinion as to whether the surgery their child received was necessary. Dr Colm Henry, chief clinical officer at the HSE, told politicians that a number of international experts have been identified, and the HSE is 'getting legal opinions to make sure we have robust terms of reference'. That process will 'take us until September', he said, adding: 'We expect assessment will take us right into the end of this year and into the next year because of the number involved'. 'We'll support parents and their children in any way they need when we're communicating these reports,' he added. Lucy Nugent, chief executive of CHI, said multidisciplinary team review clinics for the 500 children identified in the audit have started. Only 60 of these patients have been seen so far. Ms Nugent, who took up the role of chief executive in January, could not say if parents had informed consent around the novel procedure used by surgeons in the two hospitals that the surgeons believed was less invasive and could be performed earlier. Dr Henry said there was 'no evidence' found during the audit process that the kind of conversations you would expect to take place to explain the risks of surgery had occurred. In relation to an unpublished report from 2022, which suggested some children may face negative health outcomes due to delays in their care, Ms Nugent said there were 34 children who were identified as 'Crumlin orphans'. She added that 'to the best of my knowledge' these families were not notified following the completion of the report which highlighted concerns about their care. Asked why the report, which has since been referred by the HSE to the gardaí, was not reported to law officials earlier, Ms Nugent said the 'unsubstantiated' allegations were investigated at the time, and it was decided 'it did not meet the threshold for criminality'. Labour's health spokeswoman, Marie Sherlock, asked the bodies if there were other reports of concern, with Ms Nugent stating there is another report on orthopaedic paediatric services still ongoing and that will be published in due course. Eilish Hardiman, the former chief executive but now CHI'S strategic programme director, said there are 'reviews of individuals' that are going through HR processes within the organisation, but that the organisation 'would not be disclosing those'.
RTÉ News
3 days ago
- Health
- RTÉ News
Health committee to hear CHI apology over practices
Executives and senior clinicians from Children's Health Ireland are appearing before the Health Committee this morning to update politicians on spinal surgeries, the recent hip surgery review and other governance issues at CHI. Chief Executive Lucy Nugent will apologise to the children and families impacted by recent revelations about CHI's culture, governance and practices, which she says have "led to great pain being inflicted upon some of those who were in our care". Ms Nugent is in her current post five months, having started her career as a nurse in CHI Temple Street. In recent months, members of the opposition have detailed what they called "unnecessary" hip surgeries from an unpublished report into practices at three CHI hospitals. The review into Developmental Dysplasia of the Hip, or DDH, found that the majority of children who had pelvic osteotomy surgery at CHI Temple Street and the National Orthopaedic Hospital in Cappagh did not meet the threshold for surgery based on the criteria used for the audit. Children who had surgery at Crumlin were found to have met the threshold. Ms Nugent will tell the committee that the family of one child they identified who experienced complications due to surgery has been contacted and supported through an open disclosure process. She will also say that all families have now been contacted about the next steps, and if their child was part of the audit. Multidisciplinary team review clinics have begun seeing patients, with 60 seen so far. CHI has said the aim of the review clinics is to assess complications only, and it hopes to have all children seen within six months. Ms Nugent will say she does "not underestimate the stress and anxiety that families are rightfully feeling throughout this audit process." "To one family in particular, whose child experienced complications during their care in Children's Health Ireland, I extend my heartfelt apology. I would like to give my assurance to all of the families affected, that they will be directly supported and are being contacted with follow up information and the next steps." Separately, the HSE is currently developing an independent review into hip surgeries going back to 2010, to determine if harm has occurred for any child, as the original audit does not establish this. Going forward, any child who is listed for hip surgery with CHI will have their case discussed at multidisciplinary team meetings. On the recent report into culture and governance issues at CHI and the use of the National Treatment Purchase Fund, Ms Nugent will apologise for not being at liberty to publish the report, saying it is her legal duty not to do so, despite media reports. Executives at CHI will also update the committee on progress in paediatric spinal surgery services. At the start of June, 48 patients were waiting over four months for surgery, a decrease since the start of the year. CHI will also say that 223 spinal procedures have been completed in the year to date, up on 196 such operations at the same point last year. An additional Consultant Orthopaedic Spinal Surgeon is due to start in August, with recruitment under way for a further three consultant orthopaedic surgeons.
Irish Times
10-06-2025
- Health
- Irish Times
Letters to the Editor, June 10th: On clinical governance, alcohol tax and gardening leave
Sir, – I write as both a mother and a scientist. In 2023, when my daughter was just four years old, she was recommended for hip surgery to treat developmental dysplasia of the hip (DDH) under the care of Children's Health Ireland (CHI). We were deeply concerned about whether the procedure was truly necessary and ultimately chose to decline it. We sought a second expert opinion who reviewed her medical records and imaging, confirming what we had feared: our daughter no longer had DDH and had never needed surgery in the first place. We were lucky. Too many families were not. The revelations about unnecessary hip surgeries are just one part of a far wider institutional collapse. From the use of non-medical grade spring devices in spinal surgeries, to the misappropriation of National Treatment Purchase Fund (NTPF) resources, what's becoming clear is that these failures are not isolated – they are systemic. Clinical governance, patient safety, and ethical standards were compromised across CHI. Children with complex needs were not treated with dignity or respect, but as burdens to be managed. READ MORE As a scientist, I am appalled. I cannot comprehend how invasive surgeries were conducted without solid clinical evidence, peer oversight, or proper audit. This betrays the most basic principles of evidence-based medicine. As a parent, I am devastated. The very system meant to care for our children ignored parental concerns, dismissed expert warnings, and placed vulnerable lives at risk. This crisis did not emerge in silence. Since 2017, advocacy groups – many led by parents – have raised alarms about systemic dysfunction within CHI. Their warnings were persistent, informed, and largely ignored. Had they been taken seriously; my daughter would never have faced this decision – and countless other children might have been spared real harm. We cannot accept vague apologies or bureaucratic delay. What is needed is a full public enquiry, criminal investigations where warranted and accountability at every level of CHI and the HSE, and binding reforms to ensure this never happens again. The lives and the futures of children depend on it. Ireland's children deserve care that is safe, ethical, and humane. Nothing less. – Yours, etc, DR THERESE MURPHY, Lecturer in Molecular Diagnostics and Bioinformatics, School of Biological, Health and Sports Science, Technological University Dublin, Dublin. Alcohol consumption and tax Sir, – The recent report showing a 4.5 per cent drop in alcohol consumption in Ireland last year ( 'Alcohol consumption falls 4.5 per cent, putting Irish at European average,' June 9th ), is welcome news, reflecting healthier public attitudes and the success of evidence-based policy, including minimum unit pricing. However, the suggestion from the Drinks Industry Group of Ireland (DIGI) that this progress should now justify a cut in alcohol excise duty is deeply misguided. Alcohol continues to cause enormous harm in Irish society, with thousands of lives lost or devastated every year through liver and heart disease, dementia, breast cancer, domestic abuse and more. Each year, alcohol costs the Irish State billions in healthcare, policing and lost productivity. Alcohol taxation remains one of the few public tools that reduces consumption while raising vital revenue to offset just a small fraction of the costs alcohol imposes on society. If anything, our alcohol excise rates urgently need revision as despite rising costs and inflation, they have remained essentially unchanged since 2014. Most Irish citizens do not know or understand the risks of alcohol consumption. The dangers of alcohol, particularly its links to cancer, cardiovascular disease and cognitive decline, remain hugely under-recognised. The unambiguous position of the World Health Organisation needs to be better known: no level of alcohol consumption is safe for our health. – Yours, etc, DR RALPH HURLEY O'DWYER, Specialist Registrar in Public Health Medicine, Dublin. Gaza and food aid Sir, – I'm delighted by the international impact of the Madleen, due to the presence of Greta Thunberg and other international activists. I wonder have your readers forgotten the 2010 Irish endeavour to respond to the tragedy of an earlier Palestinian Nakba. Together with Malaysian support, we purchased a ship which carried 60 tonnes of cement for rebuilding essential humanitarian infrastructure in Gaza. And significantly, onboard was Mairead Maguire, winner of the Nobel Peace Prize. The ship we named the Rachel Corrie after a young Jewish girl who gave her life in trying to stop the bulldozing of a Palestinian home. As in the case of the Madleen, we were intercepted by Israeli forces in international waters. The Rachel Corrie was boarded from two Israeli gunships and we were taken into Ashdod. There were seven Irish and seven Malaysian activists onboard. Malaysia had assembled the funding for the purchase of the ship, which was fitted out in Dundalk, and where a retired Scottish captain was hired. The then minister for foreign affairs, Micheál Martin, contacted me via satellite phone to express his concern for the safety of Irish nationals, and to inform me that he had been in touch with the Israelis. I explained that, in addition to delivering cement to Gaza, we intended to enter Gaza, just as our friends onboard the Madleen had intended. In both cases, the attempt was to break the stranglehold over Gaza and the people of Gaza by Israel. Micheál Martin understood the situation, and arranged for the Irish ambassador to meet me in Ashdod after our arrival at the detention centre. At his request the ambassador met me, and together with his Thai counterpart, he agreed to get the Filipino crew, the Cuban engineer, and the Malaysian activists out of the Israeli prison as soon as possible. These were all citizens of countries that did not recognise Israel. We Irish had agreed we would not leave detention until the other shipmates including the Scottish captain had been freed and flown home. Our opportunity to prosecute Israel for military action in international waters was not taken up by Ireland or Malaysia, regrettably, and now we see the same violation of international law taking place. – Yours, etc, DENIS J. HALLIDAY, Former UN assistant secretary general (1994-98) Ranelagh, Dublin 6. Sir, – In light of the Gaza genocide can we stop pretending there is such a thing as international law. Countries only talk about it when it is broken by another. It is only enforced when it is opportunistic for wealthy powerful countries. Instant action occurs when container ships are threatened, but none when humanitarian aid is in international waters under a British flag. – Yours, etc, JANE JACKSON , Greystones, Co Wicklow. Sir, – How ironic to see Israeli defence soldiers handing out food and water to protestors who themselves were trying to force Israel to hand out food and water to starving Gazans. – Yours, etc, DAVID CURRAN, Knocknacarra, Galway. Gardening leave and the HSE Sir, – The two HSE employees who have been on gardening leave for 11 years must have very fine specimens by now. ( 'Two staff on gardening leave for 11 years,' June 9th). In this other world 'gardening leave' is a term used to describe a short-term paid absence from work between two employments. But in the public sphere it means being paid indefinitely (eleven years and counting) to do nothing. Why would the gardener even contemplate the possibility of alternative employment in these circumstances? Martin Wall reports the HSE as saying that it endeavours to carry out all investigations 'as expediently as possible'. I think 'expeditiously' may have been intended but 'expediently' fits the bill beautifully. – Yours, etc, PAT O'BRIEN, Rathmines, Dublin 6. Sir, – Two HSE staff on gardening leave for 11 years . Clearly, they are creating something spectacular for Bloom. -– Yours, etc, FRANK J BYRNE, Glasnevin, Dublin 9. Sir , – I see that two HSE employees have been on 'gardening leave ' for 11 years. With such experience perhaps a transfer to the Botanic Gardens would be in order. – Yours, etc, HUGH PIERCE, Co Kildare. Some guides to St Stephen's Green Sir, – Your interesting recent supplement on St Stephen's Green (' A guide to who owns St Stephen's Green ', June 7th) reminded me how 21 years ago, when the shiny new Luas first pulled into Stephen's Green West, I suggested by letter to your paper that the four very functionally named thoroughfares surrounding the Green revert to their historical more attractively sounding monikers: ie. Stephens Green East – Monk's Walk, West – French Walk, South – Leesons Walk and North – Beaux Walk (as shown on Rocque's Map 1757). All this time later 'You are now approaching French Walk' would still sound so much more sublime as you glide in on the Luas or stroll on to Beaux Walk towards the Shelbourne. Ah let it be done, a little renaming enhancement to uplift further this famous old marshy Square! – Yours, etc, HELEN KEHOE, Stoneybatter, Dublin 7. Sir, – The headline 'A guide to who owns St Stephen's Green,' caught my attention. I was afraid the ownership of the public park had moved to the private sector and I'd be reading how the bandstand could now be rented for €3,000 per month. So it was delightful to discover it only referred to the property around the rectangular Green. – Yours, etc, DERMOT O'ROURKE, Lucan, Dublin. Some pointers for the GAA Sir, – I could not agree more with Nicky English's analysis of Saturdays Munster final in Limerick at 18.00hrs on a Saturday evening. (' Weary Limerick's errors allowed Cork's confidence to flourish,' June 9th). I was one of the spectators who because I had to walk (my running days are over!) left the stadium at half time in extra time to catch the 21.00hrs train back to Dublin. Let me declare an interest, I am a Corkman who loves the game of hurling and obviously delighted with the result. The performance by both sets of amateur players on Saturday was up there with the best I have been privileged to witness over the years. I'll leave it to your columnists and others to describe the passion, excitement etc. of the game but would add some observations, which are meant to be constructive. The core issue with the scheduling of games in both codes is the contraction of the season. It is an issue needing immediate attention to be sorted for the 2026 season. There are so many reasons why it should, all of which have been well articulated, and I can honestly say I have yet to meet a supporter of either code who agrees with the short season for our inter county championships. I fully agree with Nicky's comments on refereeing. I have been arguing for a long time that the game is too fast and hectic now for one referee and in my opinion we should have two, each in full control of their own half, at least for major championship games. I also agree the new football rules in relation to the clock and hooter should be implemented as should some disciplinary measures on dissent and gamesmanship. Not so sure about revaluing the goal to four points! When I entered the Gaelic grounds at 17.40 hrs on Saturday and Croke Park at 15.30 hrs on Sunday there were no programmes for sale. Why? and please don't tell me they were all sold out!! Another issue which I don't like bringing up is the toilet facilities at our stadiums. The scene under the Mick Mackey stand during the intervals on Saturday can only be described as appalling, disgraceful, third world. Whatever about men jamming the entrances/ exits trying to get in and out , the sight of our women supporters, who are growing in such numbers, lining up in orderly lengthy queues is so so embarrassing and must be so demeaning for them. I don't accept there is no solution to this problem in this age of mobile units which we see deployed in other venues throughout the country. – Yours etc. JOE WALSH, Sutton, Dublin. Gulf stream and climate change Sir, – A recent letter from Richard Herriott (my first cousin as it happens) queried why the Environmental Protection Agency's (EPA)latest report did not mention the possible collapse of the Atlantic Meridional Overturning Circulation – more popularly known as the Gulf Stream. While the concern is valid, the omission is understandable. The EPA's focus is on Ireland's emissions and our domestic climate action. The destabilisation of the Gulf Stream is indeed one of the most alarming global climate tipping points, but it is also largely beyond our direct influence. In contrast, the report highlights the many areas where we can make a difference – reducing emissions from transport, agriculture, buildings, and energy. These are spheres where policy and behavioural change can yield real and measurable results. The real scandal is not what the report left out, but what we continue to leave undone. We are failing to act even where action is clearly within our grasp. It would be tragic if, in the face of potential planetary upheaval, we chose to focus on the immovable rather than the urgent and fixable. Or we could do a Nero and pull out a fiddle. – Yours, etc, JAMES CANDON, Woluwe St. Pierre, Brussels. Season's Greetings Sir, – At 9.20 am on Monday June 9th, an out-of-service bus passed me on Kevin Street, Dublin 8, bearing the greeting, 'Merry Christmas from Dublin Bus' on its display screen. Is this a record? – Yours, etc, MARK HARKIN, New Bride Street, Dublin 8.
Irish Examiner
09-06-2025
- Health
- Irish Examiner
Screening to help babies avoid hip dysplasia surgery still not in place, eight years on
A national screening programme to help babies with hip dysplasia avoid surgery is still not in place eight years after it was recommended. The steering group that made the recommendations was disbanded by the HSE this year. However, none of its recommendations have been implemented. Up to 100 children a year undergo invasive hip surgery because of a late diagnosis, it is estimated. In 2017, the steering group recommended the introduction of a national screening programme to avoid any unnecessary surgeries. Last year, the watchdog, Hiqa, raised concerns that the recommendation had still not been acted on. The watchdog said: 'Current practice is, therefore, not supported by the governance, end-to-end care, quality assurance, and monitoring of outcomes that would be associated with such a programme.' They found evidence that even in the limited approach taken to screening, 'there may be variation in the implementation' between hospitals. One consultant said that if problems with hip dysplasia are detected early enough there might not be any need for surgery. The consultant said: 'Problems arise when the diagnosis is made late. The sooner you spot it, you can treat it in a harness or a brace. And the children respond very well and have excellent results.' However, without a national register, the consultant said: We have no idea what the national rate of late diagnosis is. I would guess there are probably 80 to 100 babies per year who are presenting with late diagnosis. The consultant, who is familiar with care for hip dysplasia, said: 'The whole point about DDH [hip dysplasia] is if you treat it in time, it can nearly all be done non-operatively.' In recent weeks, there has been public outrage over the high number of surgeries and unnecessary surgeries in CHI at Temple St and the National Orthopaedic Hospital, Cappagh. The consultant said: 'In the recent CHI report, if you subtract the unnecessary operations from the overall number, you are left with a lot of necessary operations. In many cases, it is likely that they were necessary because of late diagnosis.' There is now concern in health circles at what the CHI crisis could mean for efforts to address the gaps. 'The whole thing is in chaos now. It's probably seen as toxic. There is no sense of urgency, no sense of determination to get this done,' the consultant warned. Sinn Féin health spokesman David Cullinane said that not only were recommendations not implemented, but also 'no national database or audit was ever put in place'. The recent scandal in to unnecessary hip procedures on children demonstrates the importance of the recommendations of the working group. 'It is worrying that these recommendations were not implemented and this has caused understandable concern for those involved in this valuable work.' The HSE said health regions are now responsible for screening. The Department of Health pointed to communication from the NSAC last month to doctor's groups who raised concerns saying the best approach 'would likely be the systematic application of the current selective screening programme'.
Time of India
06-06-2025
- Business
- Time of India
Odisha mangoes now in France, Belgium as exports soar
In a breakthrough, Odisha has successfully added France and Belgium to its list of mango export destinations, reinforcing the state's emergence as an agricultural export hub . This achievement adds to an already growing list of international markets, including Dubai, London, Birmingham, Rome, Venice, and Dublin. Gitashree Padhi, Deputy Director of Horticulture (DDH), Dhenkanal, said, 'The global acceptance of Odisha mangoes in markets like France and Belgium reflects the potential of our farmers and the strength of our horticultural ecosystem.' During the first week of June 2025, 13.4 metric tonnes (MT) of mangoes were exported to London and Dubai, significantly contributed by Farmer Producer Organizations (FPOs). The exports were made possible through active involvement from the Saptasajya Farmer Producer Company, Dharitree Agro Plus Company, Kankadahad Farmer Producer Company and Sugandha Farmer Producer Company. Since exports began in May 2024, Odisha's agri-export volume is nearing 100 MT, with mangoes — especially Amrapalli and Dashehari varieties — making up a significant percentage of the total. Expanding into new markets has delivered direct benefits to Odisha's farming communities. Farmers have earned 40–60% higher prices for their mangoes, enabled by direct export access, improved quality standards, and aggregation through FPOs. In 2024–25, Odisha entered seven international markets. In the first few months of 2025–26, the state has already exceeded that number, both in terms of destinations and export volumes. This growing momentum reflects the Odisha government's focused efforts to establish the state as a leading agri-export centre.
