What's the story with Children's Health Ireland?
Three members of the board of Children's Health Ireland (CHI) resigned on Tuesday morning, after months of controversy at the operator of paediatric healthcare in the State.
CHI was established in 2019 to govern and operate paediatric services in Ireland, and currently operates Temple Street, Crumlin and Tallaght hospitals. It will also operate the new National Children's Hospital upon completion.
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In recent times, there have been a number of controversies in the hospital, including ongoing delays with the completion of the National Children's Hospital, the implantation of unapproved springs into children with scoliosis, the threshold for hip surgeries, and surgical outcomes for children in the orthopaedic service.
The Children's Health Ireland group is a separate entity from the HSE, although it is funded by the HSE and accountable to it.
Who resigned?
A total of four board members of Children's Health Ireland have resigned over the past week, after months of controversy at the operator of paediatric healthcare in the State.
Dr Gavin Lavery, Brigid McManus and Catherine Guy tendered resignation letters to the Health Minister on Tuesday morning, following on from the resignation of Mary Cryan last week.
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Ms Cryan is a former HR director with the Brown Thomas Group, and former employer member of the Labour Court.
Dr Lavery is a former ICU physician, president of the intensive care society of Ireland and clinical director of HSC Safety Forum (NI).
Ms Guy is currently chief executive of NiftiBusiness and a former managing partner of ByrneWallace Law Firm in Dublin, while Ms McManus is a former secretary-general at the Department of Education and Skills.
That means 40 per cent of the CHI board have resigned in the last seven days.
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In April, the chairman of the CHI board Dr Jim Browne also resigned following the publication of a critical report into the use of springs in child spinal surgery.
Minister for Health, Jennifer Carroll MacNeill, confirmed the resignations during an interview on RTÉ Radio.
She today updated Cabinet on the actions taken to improve the governance of CHI and the National Orthopaedic Hospital Cappagh (NOHC) following last week's clinic audit report on hip surgeries.
Ms Carroll MacNeill said HSE chief Bernard Gloster has agreed to respond to the report and its implications within the next week. She will also update on the appointment of two HSE board members to the CHI board as well as a strengthening of the Service Level Agreement between the HSE and CHI.
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Ms Carroll MacNeill said that she had "strong questions about the governance of CHI and its direction towards the future" and that there had been three resignations from the board this morning.
"We need to have a functional governance structure to enable us to get to the opening of the Children's Hospital and to deal with the many issues in children's health," she told RTÉ Radio One.
Ms Carroll MacNeill said she was not empowered by law to ask for the resignations. She said there were now seven people on the CHI board, including two she appointed over the weekend from the HSE board.
'There are seven people on it that were appointed in 2025 or in 2024. There are now three additional vacancies, and I will be looking to make similar appointments over the next number of days.'
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Controversies
This all comes after several controversies involving CHI, including a report published on Friday that found many children underwent 'unnecessary' hip surgeries in two Dublin hospitals.
The clinical audit of dysplasia of the hips surgeries in children found that a lower threshold for operations was used at CHI Temple Street hospital and the National Orthopaedic Hospital Cappagh (NOHC) than the threshold used at CHI Crumlin.
The review discovered that in the period 2021 to 2023 almost 80 per cent of children operated on at the NOHC, and 60 per cent of those at Temple Street, did not meet the threshold for surgery.
The 2,259 children who underwent hip surgeries in the three hospitals (NOHC, CHI Temple Street and CHI Crumlin) from as far back as 2010 will now be subject to clinical reviews.
Opposition TDs have called for a public inquiry and for CHI to be fully subsumed into the HSE.
People Before Profit TD Paul Murphy said the hip dysplasia issue was a 'horrendous scandal' and there was a 'very fundamental problem of governance' in CHI.
'I think CHI is not fit for purpose as currently set up. I think that's kind of part of what a public inquiry needs to look at, but it needs to be quick.'
In an interview on RTÉ Radio One's This Week programme, HSE boss Bernard Gloster said that t
he potential for Children's Health Ireland (CHI) to be fully subsumed into the HSE will be one option considered amid concerns around clinical care and governance.
Mr Gloster was asked if the issues highlighted by the report were down to bad decisions by doctors or a bad system.
'It can be a combination of any of those and rarely in a deficiency in a healthcare system will it come down to one single part of that,' he said.
Asked if there would be accountability for individual surgeons, Mr Gloster highlighted that CHI and NOHC were the employers, not the HSE.
But he said the question of accountability was 'fair and appropriate'.
He said there were also questions about the governance of the institutions involved.
The Health Information and Quality Authority (HIQA) found in April that the use of springs in spinal child surgery, which were of a non-medical grade, was 'wrong'.
The springs were used in three operations carried out by a surgeon at CHI's Temple Street.
On Sunday, Mr Gloster was asked if the option of subsuming CHI into the HSE was being considered, he replied: 'The minister wants to consider all of the options. And, of course, when she sets out all of the options, that has to be one that gets considered, but it is not the only one.'
Mr Gloster added: 'The job of the executive, the job of CHI, the job of the doctors and everybody else today is leave the minister to do her job. She will do that very well and give us policy direction.
'We need to get on with looking after these children and with supporting their families.'
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