In 2018, then minister for health Simon Harris issued a press statement expressing his delight at the passing through the Oireachtas of the Children’s Health Bill, under which there would be a single statutory entity to run paediatric healthcare in the State – Children’s Health Ireland (CHI).
“This is an extraordinary opportunity to transform paediatric services for children in Ireland and will improve the experience and outcomes for children and their families,” his statement said at the time.
In January 2019, it assumed control of children’s health services. But just over six years later, the controversies facing the body have continued to stack up – creating concerns that the experience and outcomes for children are not as good as they should be in some services.
Many of the issues centre around the orthopaedic services. In 2017, concerns were raised about the length of time children with scoliosis and spina bifida were waiting for surgery.
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It was pledged no child would wait four months for surgery by the end of that year. This promise has still not been met, and clinicians question the basis behind the four-month deadline.
Then came concerns around the implantation of non-medical grade springs into three children with scoliosis and spina bifida.
A report was commissioned and recently published by the Health Information Quality Authority (Hiqa), which found the springs were used without ethical approval, managerial approval or the informed consent of parents.
It also highlighted governance issues in the hospital, stating a failure of controls meant “children were not protected from the risk of harm”.
Last week, an independent audit examining a three-year period was published which found 60 per cent of surgeries for developmental dysplasia of the hip (DDH) in Temple Street were not necessary, while 79 per cent of the procedures in National Orthopaedic Hospital Cappagh (NOHC) did not meet the clinical threshold for surgical intervention.
[ Analysis: What’s in the hip surgery audit and how much harm has been done?Opens in new window ]
A further report, by UK expert Selvadurai Nayagam, is being conducted into paediatric orthopaedic surgery service at CHI Temple St, CHI Crumlin, the National Orthopaedic Hospital, Cappagh, and other relevant sites in Dublin following concerns around adverse outcomes.
Most recently it emerged that an internal review at Crumlin hospital from 2021 found a consultant was allegedly referring public patients to his private clinics, which he runs separately.
This, according to the Sunday Times, which first reported the findings of the review, delayed operations for sick children by up to three years, with the funding for some of these clinics coming from the National treatment Purchase Fund (NTPF), which seeks to reduce hospital waiting lists.
This inquiry was not sent to any senior Department of Health officials nor senior HSE officials, Minister for Health Jennifer Carroll MacNeill said, adding that the review raises “very, very, very serious considerations for me”.
Lucy Nugent took up the role as chief executive of CHI in January, and all of the issues that have emerged in recent months predate her start.
Steps have also been taken to improve services; the body has accepted all findings and recommendations of the reports published to date, and are outlining plans of how they intend to enact these recommendations.
But as all of this is happening, CHI is due to take over the new National Children’s Hospital when it opens to patients next year.
Ms Nugent expressed confidence last week at a meeting of the Public Accounts Committee that CHI would be able to commission the hospital once it is handed over to them.
But given the hospital has already been beset by cost overruns and delays, it is no wonder concern abounds and serious consideration is being given about the way in which CHI will operate in the future.
