Spinal surgeries scandal has the ring of such grotesquerie as to stop a country in its tracks

Ireland is a land rich with children’s fairy tales. There once was even a president of the country whose wife, Sinéad Bean de Valera, wrote books of magical Celtic fables. The adventures of Oisín in Tír na nÓg and Fionn Mac Cumhaill with his salmon of knowledge wove a comfort blanket that our forebears wrapped around themselves. “Ireland is the best country in the world to bring up children,” they assured one another.

“I had one pair of shoes, and Santy brought me an orange for Christmas,” my mother used to recall of her 1930s upbringing on an east Cork farm. She didn’t know how lucky she was. Other children had no shoes and no Father Christmas. They were dying of malnourishment and curable illnesses, being imprisoned or sent to industrial schools through no fault of their own, or being buried in mass unmarked graves as if they had never existed.

“I watched the girl from America spread peanut butter jelly on her bread at breakfast in school when the rest of us only had marmalade with thick chunks of lemon rind,” I told my child. I didn’t know how lucky I was. Other children were being sold for adoption in America or, down the road in Bessborough mother and baby home, they were being used, without licence or consent and with no more autonomy than lab rats, in vaccine trials.

[ Spinal surgery failings: ‘Sad little faces’ of TDs are no good to children, says group ]

What will our children tell their children? That Santa only brought them Barbie’s pink Corvette when they had asked for her Dream House too? How long will it take for the other voices to be heard above the din of higher expectations? The voices of children deprived of mental health services, of children in care who are being sexually exploited, of children who fled war and torment in their birth countries only to languish in Ireland’s hopelessly inadequate asylum system, of caravans of nomadic children always being moved along in the never-ending homelessness crisis.

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Add to those the children with painfully disabling spinal conditions who have had to wait years for corrective surgery while their spines curved so acutely they squashed their lungs. Some children have had to be strapped into wheelchairs to ensure they would not fall out when they were in school. Now we learn that 13 of 19 young people who underwent spinal operations in the Children’s Health Ireland (CHI) hospital at Temple Street, Dublin, were subjected to further surgeries following post-operative complications.

The hospital was aware the surgeon’s work was being questioned but still allowed the doctor to go on operating on children

According to two reviews, one external and the other internal, in 16 cases that were analysed, 13 patients needed extra unplanned operations after the initial surgery by a particular consultant. One child, Dollceanna Carter from Trim, Co Meath, who had spina bifida and scoliosis, died in September aged 10 following numerous procedures.

It emerged officially in the HSE’s press release on Monday that the doctor had implanted non-medical-standard compression springs in young patients. This has the ring of such grotesquerie as to stop a country in its tracks, yet there is no evidence that the hospital authorities treated the burgeoning scandal with any sense of urgency. To the contrary, the surgeon continued doing surgeries for another year after a “particularly serious surgical incident” in July 2022.

A second incident occurred two months later, after which staff began voicing worries about the surgical consequences suffered by children operated on by the consultant. Despite these alarms, the doctor was still performing complex surgery until last November, and only ceased doing any surgery in July. Presumably, somebody in authority deemed that safe practice.

[ Spinal surgeries review: Child with spina bifida required 34 operations at Temple Street ]

The gaps in information supplied by CHI are disquieting. What was the source of the springs used in the operations, for example? Did the doctor bring them to work in a jacket pocket or were they supplied from hospital stores? Was this doctor conducting more complex surgeries than his or her colleagues, thus inevitability incurring a higher incidence of post-operative complications? The fact that the HSE has ordered yet another review, this one covering all CHI hospitals, indicates a level of dissatisfaction with how this awful scandal has been treated.

On its website, CHI says its “clinical vision” is to deliver “the right care in the right place at the right time by the right staff”. According to its own account of events, the hospital was aware the surgeon’s work was being questioned and that, ergo, the person might not fit the description of the “right staff”, but still allowed the doctor to go on operating on children. Surely the Hippocratic Oath to do no harm should apply to hospital administrators and well as to medical professionals?

Taoiseach Leo Varadkar, who is a doctor and a former minister of health, has said the possibility must be considered that what happened is not solely a matter of one individual’s work but “a wider failure of clinical governance”. If the next review finds a failure of clinical governance was the fault line, the €2 billion construction bill for the new national children’s hospital may be the least of its problems.

Not only is CHI the operator-designate of Ireland’s national healthcare centre for children whenever the controversy-ridden facility finally opens, it will also take charge of paediatric education, research and innovation. For these reasons, as well as for fairness to the children and families who have suffered, the series of appalling events in Temple Street must be fully revealed to the public.

[ Review of Temple Street spinal surgeries could take at least a year, says HSE chief ]

Reciting the mantra of legal considerations as an obstacle to publication of all the facts would be abominable. There are ways of unambiguously setting out what happened without identifying individuals if needs be. Children’s lives are worth more than lawyers’ bills.

Many parents have experienced Ireland’s paediatric hospitals and have witnessed the kindness and the dedication of those who work in them – including Temple Street – often without adequate resources. In recent years, promised extra operating theatres have not been delivered while brick was being placed slowly upon brick at the new hospital’s construction site. Children should not have to wait for essential surgery while builders and politicians squabble over the bill.

Ireland is no utopia for every child. It never was. Every generation has had its cohorts who were treated as though they were dispensable – the poor, the orphaned, the offspring of unmarried parents, those of the Traveller community, those with disabilities, those with psychiatric needs, young immigrants. And still we comfort ourselves with our most abiding fairy-tale that this is Tír na nÓg for all.