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Irish Times
4 days ago
- General
- Irish Times
Revelations show appalling personal behaviour among some CHI medics
With the very future of Children's Health Ireland up for discussion in Government, further revelations about a toxic work culture operating in part of one of its hospitals will bolster the case of those who believe the organisation should simply be subsumed into the Health Service Executive . Even among those who favour its continuation as an independent entity, there are serious doubts as to whether CHI, which is responsible for the governance and operation of the three paediatric hospitals in Dublin – Temple Street , Crumlin and Tallaght – is fit for the job of running the new national children's hospital. Waves of scandal and controversy have overwhelmed the organisation in recent months. A recent report found that most hip surgeries carried out on children were unnecessary . Prior to that, it emerged that devices not cleared for surgical use were inserted into children suffering from scoliosis – the management of which has been another long-running controversy. READ MORE Its chairman and four board members have resigned. The revelations today have been quietly circulating in senior health and political circles in recent days, where they have shocked even the most hardened veterans of scandals in the health services. They paint a picture of an almost unbelievably toxic culture that was operating in a part of one of the CHI hospitals – to the extent that 'numerous participants' who took part in the confidential survey process 'expressed concern for the emotional and physical wellbeing of colleagues working in the service'. [ Report reveals 'toxic culture' among consultants at CHI hospital Opens in new window ] Repeatedly, throughout the report, the conclusions of the observers and the testimony of the employees who participated in its inquiries show that a culture of extreme toxicity characterised the operations of part of the CHI hospital. While one consultant – who is not identified by name in the report – features prominently, there are also complaints about other consultants and a hospital management unable or unwilling to deal with the consequences of the behaviour of some senior medics. Relationships between certain senior clinical figures deteriorated to the extent that one consultant instigated a legal action for defamation against another. 'It is reasonable to assume that such a case can only arise as a result of the fraught relationships within the ... service,' the report notes. 'Fraught relationships' seems to be something of an understatement. The toll on medics who were training under some of the consultants was especially acute. They spoke of 'bullying' and 'harassment', being subjected to 'humiliating and intimidating experiences' and of an 'environment where an individual feels they may be punished or humiliated for speaking up with ideas, questions, concerns or mistakes'. The report also includes details of how the National Treatment Purchase Fund (NTPF) may have been abused by the manipulation of waiting lists. Pointing to a greater number of patients seen in private time slots than at public clinic, it asks: 'Was throughput prioritised over patient care in NTPF clinics, noting there is a €200 fee per patient, or are the public outpatient clinics failing to operate at full capacity?' Yesterday, the Sunday Times reported that Minister for Health Jennifer Carroll MacNeill had ordered a full audit of governance and practices at CHI. There are very clearly significant systemic failings in parts of the organisation and in the hospitals for which it is responsible. But the revelations today show something else too: appalling personal behaviour by some senior medics which damaged the care that patients in the hospitals received. Some trainees felt punished and excluded, belittled and victimised, to the extent that some felt that the experience – 'working in a hostile environment', as one said – had a detrimental effect on their lives. Aside from the personal consequences for people subjected to the behaviour of some senior colleagues, the report points out repeatedly that it creates an atmosphere that damages the care of patients. Aside from individual instances detailed in the report, the toxic relationships also poison the atmosphere where people are supposed to be working together for the benefit of the patients. 'The communication style, accusatory language and indeed unprofessional antics that continued over this period add to further compromise interpersonal relations, heighten levels of mistrust among colleagues and ultimately are a distraction from patient-centric care,' it found. 'Consistently throughout this examination, it was found that participant experiences reflected a culture in which challenging behaviour appears to be the norm,' the report found. 'It is critical that an organisation takes time to reflect on and own the culture that exists and then seeks to address the issues and bring about the required change.'
Irish Times
28-05-2025
- Business
- Irish Times
Children's Health Ireland may be merged into HSE following recent controversies
Minister for Health Jennifer Carroll MacNeill is actively considering subsuming Children's Health Ireland (CHI) into the Health Service Executive (HSE) following recent controversies at the operator of paediatric healthcare in the State, The Irish Times understands. CHI was established in 2019 to govern and operate paediatric services in Ireland, and currently operates Temple Street, Crumlin and Tallaght hospitals. Upon completion, it will operate the new National Children's Hospital . However, there have been a number of issues in the hospital in recent years, including the implantation of unapproved springs into children with scoliosis ; the threshold for hip surgeries ; and surgical outcomes for children in the orthopaedic service. Sources have said there is a 'lack of confidence' in the body in light of these issues, with senior Government and healthcare figures expressing concern about the organisation's ability to run the new children's hospital in its current format. READ MORE Four members of the board have resigned over the past week – Mary Cryan, Dr Gavin Lavery, Brigid McManus and Catherine Guy. This follows the resignation of board chairman Jim Browne last month. Ms Carroll MacNeill said she has moved to strengthen the governance and oversight at CHI and will appoint two members of the HSE board to that of CHI. In relation to the vacancies created by the recent resignations, the Minister told RTÉ she 'will be looking to make similar appointments over the next number of days'. 'Further measures are also under consideration,' the minister said in a statement. Several sources have confirmed the measures include subsuming CHI into the HSE. The takeover would be supported by the HSE, with Bernard Gloster , chief executive of the body, at the weekend stating this option 'has to be' one of the moves considered. This is not the first time the takeover has been considered by Government. Last December, The Irish Times reported that then Minister for Health Stephen Donnelly sought legal advice on the powers available if the State considered it had to take over the operation of children's services. It is understood the legal advice was that such a direct intervention could only take place if an independent review identified serious governance or other failings. Since then, the Health Information and Quality Authority published an independent report on the implantation of non-surgical springs into three children with scoliosis in Temple Street hospital. [ Watchdog report to criticise surgeon over use of unauthorised springs in spinal operations Opens in new window ] The report found the use of these springs were 'wrong' and the systems in place in CHI meant 'children were not protected from the risk of harm'. An independent audit published last Friday found that almost 500 children who underwent hip operations in two hospitals should be recalled, as close to 70 per cent of the sample of operations examined in these healthcare facilities were not necessary. [ Hip surgery audit: Almost 70% of operations in two children's hospitals 'unnecessary' Opens in new window ] The audit examined only 147 cases over three years – 2021 to 2023 – and a wider inquiry into the issue will be commenced. Another report, by UK expert Selvadurai Nayagam, is also being conducted into paediatric orthopaedic surgery service at CHI Temple St, CHI Crumlin, the National Orthopaedic Hospital, Cappagh, and other relevant sites in Dublin. This report has not yet been completed. Following the publication of the audit, CHI chief executive Lucy Nugent said the organisation is 'currently standardising care across all CHI sites, so all children receive the same high-quality treatment no matter where they are seen'. Mr Gloster said the audit findings 'raise significant concern', adding that the HSE will 'now oversee the implementation of the recommendations and the comprehensive response by way of follow up with the children that the recommendations outlined in this report are implemented in full'. Separately, the Minister has also written to the CHI Board seeking an action plan in relation to an internal unpublished report concerning a consultant who allegedly referred public patients to his private clinics .
