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 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.
CHI hearing: Some children who had hip surgery may not have reviews until next year, committee told
CHI chief to apologise to patients, families and public over ‘great pain inflicted’ on some in its care
A Gaeltacht tragedy: ‘I never would have sent her if I thought anything was wrong’
Children’s hospital commentary often `ill-informed’ contractor BAM tells Minister for Health
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”.
These children received “sub-optimal care” and were not transferred to Temple Street hospital when the service was moved there from Crumlin.
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”.
Ms Nugent said the recent crises in the hospital group “keeps her up at night”.
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”.
In a statement, hip dysplasia advocacy group, a representative group formed by parents and guardians following publication of the audit, described answers by CHI as “inadequate”.
“The families deserve the right for CHI to answer their questions concisely and honestly,” the statement said.
“The main questions being: Why did my child go through this horrific procedure unnecessarily? What group of people will be held accountable? What complications will our children face in the future, when their perfectly healthy hips have been operated on?”
