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BreakingNews.ie
28-05-2025
- Health
- BreakingNews.ie
Taoiseach ‘very worried' about email from clinical director at National Orthopaedic Hospital
The Taoiseach has told the Dáil he is 'very worried' about the suspension of a multidisciplinary team's oversight of hip surgery decisions at a Dublin hospital. Micheál Martin said there needs to be an 'exhaustive' review of unnecessary hip surgeries at two Dublin hospitals. Advertisement He was responding to People Before Profit-Solidarity TD Paul Murphy during Leaders' Questions in the Dáil on Wednesday. It comes after a clinical audit of surgeries for dysplasia of the hips 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. Advertisement Mr Murphy told Mr Martin about an email from a clinical director at Cappagh which ordered an end to multidisciplinary teams considering the cases of patients listed for pelvic osteotomies, instead deferring to the decision of the individual consultant involved. He said the senior management team at the hospital was also CCd (carbon copied) on the email in November 2023. He quoted: 'Recently, it has become apparent that many children listed for pelvic osteotomies are being cancelled or are having their surgery deferred at short notice thereby causing inefficiencies on surgical lists. 'Following a meeting today, I have decided that patients listed for pelvic osteotomies will no longer be discussed at the MDT Advertisement 'It will be up to the patient's individual consultant to review the X-ray and decide if they wish to proceed.' Mr Murphy said surgeries were being cancelled because other surgeons on the MDT thought they were unnecessary, adding: 'Instead of saying there was something wrong here, the clinical director said 'we'll stop discussing them at the MDT and it'll be fully in the hands of the original surgeon to decide'.' Mr Murphy also told the Dáil about the experiences of a a mother of two daughters, Amelia and Hannah, and a surgeon at Temple Street. He said the mother felt 'unduly and inappropriately' pressured by the surgeon ahead of two osteotomies on Amelia's hips. Advertisement Later, her younger sister Hannah was spotted by the same surgeon while she was in the hospital for an eye issue. Mr Murphy said the surgeon insisted that she also needed two osteotomies despite the family being told by a doctor at the Coombe that this was not necessary. The surgeries on Hannah did not proceed. He said this was a 'chilling example' of the experiences of parents. He questioned whether there was financial motivation as if the operations had been carried out under private health insurance, the surgeon would have made €1,500 for the first hip and €750 for the second. Advertisement He said this may have had a 'significant distorting effect' and was an 'example of the poisonous role of private profit in what should be a public health system'. In response, the Taoiseach said he did not know the reasons behind the decisions which were taken and cautioned that 'private does not mean unethical'. On the email read out by Mr Murphy, Mr Martin said he was not aware of who the clinical director was but described it as a 'serious issue'. 'That seems to be a shutting down of the multidisciplinary team and the multi-disciplinary approach is a safeguard against wrongdoing or poor practice or ill-informed decisions – because the collective can inform. 'And I've met many, many consultants who will say it's the collective approach as to whether we do surgery or not. 'Medicine is not an exact science, that's why the collective is important. He added: 'So I would be very, very worried about the suspension of the MDT team in respect of assessing the necessity for operations in this area.' Mr Murphy also asked the Taoiseach if he believed the surgeons who performed unnecessary operations should be suspended or at least prevented from carrying out osteotomies until an audit into the matter is verified. Mr Martin said Amelia and Hannah's mother should formally refer the matter to the Medical Council or the authorities in CHI. Ireland What's the story with Children's Health Ireland? Read More He said there was an onus on the Medical Council to be proactive on the issue as the professional regulator. He said the CHI also needs to satisfy itself that there is no danger to future patients and that the working environment is safe. Asked if there should not be an onus on parents to request a review, Mr Martin agreed and said there should be an exhaustive examination of cases.
Belfast Telegraph
28-05-2025
- Health
- Belfast Telegraph
Taoiseach ‘very worried' about email from clinical director at Cappagh
Micheal Martin said there needs to be an 'exhaustive' review of unnecessary hip surgeries at two Dublin hospitals. He was responding to People Before Profit-Solidarity TD Paul Murphy during Leaders' Questions in the Dail on Wednesday. It comes after a clinical audit of surgeries for dysplasia of the hips 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% of children operated on at the NOHC, and 60% 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. Mr Murphy told Mr Martin about an email from a clinical director at Cappagh which ordered an end to multidisciplinary teams considering the cases of patients listed for pelvic osteotomies, instead deferring to the decision of the individual consultant involved. He said the senior management team at the hospital was also CCd on the email in November 2023. He quoted: 'Recently, it has become apparent that many children listed for pelvic osteotomies are being cancelled or are having their surgery deferred at short notice thereby causing inefficiencies on surgical lists. 'Following a meeting today, I have decided that patients listed for pelvic osteotomies will no longer be discussed at the MDT 'It will be up to the patient's individual consultant to review the X-ray and decide if they wish to proceed.' Mr Murphy said surgeries were being cancelled because other surgeons on the MDT thought they were unnecessary, adding: 'Instead of saying there was something wrong here, the clinical director said 'we'll stop discussing them at the MDT and it'll be fully in the hands of the original surgeon to decide'.' Mr Murphy also told the Dail about the experiences of a a mother of two daughters, Amelia and Hannah, and a surgeon at Temple Street. He said the mother felt 'unduly and inappropriately' pressured by the surgeon ahead of two osteotomies on Amelia's hips. Later, her younger sister Hannah was spotted by the same surgeon while she was in the hospital for an eye issue. Mr Murphy said the surgeon insisted that she also needed two osteotomies despite the family being told by a doctor at the Coombe that this was not necessary. The surgeries on Hannah did not proceed. He said this was a 'chilling example' of the experiences of parents. He questioned whether there was financial motivation as if the operations had been carried out under private health insurance, the surgeon would have made 1,500 euro for the first hip and 750 euro for the second. He said this may have a 'significant distorting effect and was an 'example of the poisonous role of private profit in what should be a public health system'. In response, the Taoiseach said he did not know the reasons behind the decisions which were taken and cautioned that 'private does not mean unethical'. On the email read out by Mr Murphy, Mr Martin said he was not aware of who the clinical director was but described it as a 'serious issue'. 'That seems to be a shutting down of the multidisciplinary team and the multi-disciplinary approach is a safeguard against wrongdoing or poor practice or ill-informed decisions – because the collective can inform. 'And I've met many, many consultants who will say it's the collective approach as to whether we do surgery or not. 'Medicine is not an exact science, that's why the collective is important. He added: 'So I would be very, very worried about the suspension of the MDT team in respect of assessing the necessity for operations in this area.' Mr Murphy also asked the Taoiseach if he believed the surgeons who performed unnecessary operations should be suspended or at least prevented from carrying out osteotomies until an audit into the matter is verified. Mr Martin said Amelia and Hannah's mother should formally refer the matter to the Medical Council or the authorities in CHI. He said there was an onus on the Medical Council to be proactive on the issue as the professional regulator. He said the CHI also needs to satisfy itself that there is no danger to future patients and that the working environment is safe. Asked if there should not be an onus on parents to request a review, Mr Martin agreed and said there should be an exhaustive examination of cases.
The Irish Sun
27-05-2025
- Health
- The Irish Sun
Latest bombshell as 3 CHI board members quit amid ‘horrendous scandal' over ‘unnecessary' hip surgeries in 2 hospitals
THREE board members of Children's Health Ireland (CHI) have resigned with immediate effect, the Minister for Health has said. Jennifer Carroll Advertisement It comes after several controversies involving CHI, including a report published on Friday that found many children underwent ' The clinical audit of dysplasia of the hips surgeries in Minister Carroll MacNeill revealed that three members - Dr Gavin Lavery, Brigid McManus and Catherine Guy - had resigned on Tuesday morning. Explaining the move, she said: 'These would be individuals who have worked on the board, worked in volunteer capacity on the board since 2018 and who have provided, you know, a very strong service in bringing the hospitals from where they were, as I said, that historical model run by the religious further. Advertisement READ MORE IN IRISH NEWS 'And they have dealt with very challenging circumstances but I think, it's also important to recognise that they have stepped down this morning, so as I look at the board.' A fourth member of the board, Mary Cryan, resigned last week. Commenting on the current situation, Minister Carroll MacNeill added: 'I have made it clear that I have strong questions about the governance of CHI and its direction towards the future. 'This is something that I've referenced a number of times in the Advertisement Most read in The Irish Sun Exclusive Exclusive 'I have a different relationship with the CHI board in statute than any other minister really has with most other boards. 'It is an unusual structure and I don't have the authority to ask people to step down in the way that you normally might expect. 'I do recognise that there have been resignations this morning and I want to thank those people for the service that they have given to the public because we recognise that these are voluntary positions. Advertisement 'And we're asking people to step out of their other lives to perform a public service in this measure." 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. Families call for action to tackle children's spinal surgery waiting list scandal Opposition TDs have called for a public inquiry and for CHI to be fully subsumed into the HSE. Advertisement The CHI hospital group is a distinct entity from the HSE, although it is funded by the HSE and accountable to it. 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.' Our Kids Can't Wait Campaign WAITING lists in Ireland have long been a national disgrace. More than 106,000 children are on hospital waiting lists for all treatments. However, a new source of shame has emerged as 327 children wait for life changing spinal surgeries. Their conditions are getting worse while they languish on waiting lists. Such are the delays, many child patients will be outside the therapeutic window when their treatments are approved. Earlier this month, the Seanad heard how at least one child has become permanently paralysed since the issue was raised publicly before Christmas. Their plight has been spearheaded by campaigning Senator Tom Clonan, who himself has a child with a disability. Former Taoiseach Leo Varadkar has even admitted that the health service is failing these kids. Children are being allowed to deteriorate due to mismanagement, which has allowed the waiting lists to grow. The Irish Sun's Kids Can't Wait campaign aims to shine a light on how the State is failing sick children and give their families a voice. It will also force the Government to do something to clear the backlog of operations and give these children a chance of living a normal life. 1 Jennifer Carroll MacNeill said those who stepped down dealt with 'very challenging circumstances' Credit: PA Advertisement
Dublin Live
23-05-2025
- Health
- Dublin Live
Dozens of children may have undergone unnecessary hip surgeries, says new report
Our community members are treated to special offers, promotions and adverts from us and our partners. You can check out at any time. More info Dozens of children who underwent hip surgeries at Cappagh and Temple Street did not meet an international expert's full criteria for hip surgery, a damning new report has found. In nearly 80% of cases at Cappagh Orthopaedic Hospital and 60% of cases at Temple Street, lower decision-making thresholds were used to decide whether surgeries should be conducted. It is likely that hundreds of children may have been operated on at a lower threshold, as it is understood that it is likely this standard was applied going back "many years". CHI and National Orthopaedic Hospital at Cappagh (NOHC) commissioned an audit after a whistleblower raised concerns about the thresholds used to decide whether to perform surgery for children with Developmental Hip Dysplasia (DHD) at Temple Street and Cappagh. This surgery relates to the failure of the full formation of the hip socket in children. It can be identified through screening and is followed up with other investigations such as X-rays and ultrasound. CHI commissioned UK-based Consultant Paediatric Orthopaedic Surgeon Mr Simon Thomas to review a random sample of surgery cases carried out on children aged between one and seven between 2021 and 2023 across Temple Street, Crumlin, and Cappagh hospitals. In total, Mr Thomas reviewed 147 random and anonymous cases across the three hospitals. The report found that there were significantly different thresholds for recommending pelvic osteotomy procedures between Crumlin, Temple Street and The National Orthopaedic Hospital in Cappagh. At CHI Crumlin, the threshold for performing hip surgeries on children was fully in line with the criteria used by the international expert who wrote the report. However, Mr Thomas raised concerns about the threshold for surgery in many cases in Temple Street and Cappagh Hospital. What was called "novel picking" was used. In this context, an existing but less invasive procedure was completed, but questions were raised about the threshold for surgery. Mr Thomas sampled 51 cases out of a total of 114 surgeries done at Cappagh. Of 70 pelvic osteotomies, just 15 met the audit criteria (21%). At Temple Street, 49 cases were audited out of 127 that took place in the hospital between 2021 and 2023. Out of 85 pelvic osteotomies, 34 met the audit criteria (40%). At Crumlin, 47 cases of 101 were audited. Of 63 pelvic osteotomies, 62 met the audit criteria This means that 79% of surgeries at Cappagh and 60% of surgeries at Temple Street did not reach the criteria required for surgery set out by Mr Thomas. The audit also identified one case from the review sample where a child experienced complications due to the surgical approach recommended to them. Mr Thomas said in many of the Crumlin and Cappagh cases sampled, there was no record of closed or open hip reduction after delayed diagnosis, no record of either hip ever having been dislocated and "often no history of treatment soon after birth by splint or brace for hip instability". All 497 cases that have undergone pelvic osteotomy at Cappagh and Temple Street between 2021 and 2023 now require ongoing follow-up to skeletal maturity. Around 1,800 children and young adults who have had this surgery at CHI at Temple Street and Cappagh since 2010 will now be reviewed. These families will be recalled and should undergo an independent clinical review and radiological assessment, the report stated. This group of patients will be contacted directly to explain what this means and the next steps for them. An external independent panel of surgeons with expertise in DDH surgery is currently being established to review all patients who underwent surgery for DDH in CHI at Temple Street from 2010 and Cappagh from 2021 to establish whether the criteria for surgery aligned with acceptable parameters as determined by the expert panel. Families will be involved throughout this process. Bernard Gloster, CEO of the HSE, said that the variance in surgical practice between Cappagh and Temple Street was concerning. He said: "The proportion of pelvic osteotomies taking place at CHI at Temple Street and NOHC, despite not reaching the international criteria used in the audit, was so high that the audit report says further inquiry is mandated. "Focus on follow-up and putting in place a mechanism to ensure this kind of variation can't recur is central to our next steps, and we will be working with everyone to ensure that this can't happen again." CHI and Cappagh Hospital have established a dedicated contact number which will be supported by clinical staff and will support patients and families who are seeking further information about their care and the next steps. The phone line is open Monday to Friday 8am to 8pm, and Saturday and Sunday 9am to 5pm. The number is Freephone 1800 807 050, or 00 353 1 240 8706 from outside Ireland. Health Minister Jennifer Carroll MacNeill said she has 'moved immediately to strengthen governance and oversight structures at CHI and NOHC'. She said: "In responding to this Report, I am thinking first and foremost of the impact a surgery has on a child. I am also deeply aware of the worry that parents will face today and this is something that is sitting with me all the time. "My immediate priority is to ensure that there is clinical follow-up and care for patients who have undergone pelvic osteotomy surgery. This follow-up will be in accordance with best practice and the recommendations of the Report." Join our Dublin Live breaking news service on WhatsApp. Click this link to receive your daily dose of Dublin Live content. We also treat our community members to special offers, promotions, and adverts from us and our partners. If you don't like our community, you can check out any time you like. If you're curious, you can read our Privacy Notice. For all the latest news from Dublin and surrounding areas visit our homepage.
Belfast Telegraph
23-05-2025
- Health
- Belfast Telegraph
Almost 500 children who had hip surgery in Dublin hospitals ‘should be recalled'
A final report of the audit was published by Children's Health Ireland (CHI) and National Orthopaedic Hospital Cappagh (NOHC) on Friday. The clinical audit of dysplasia of the hips surgery in children found that a lower threshold was used at Temple Street and Cappagh hospitals. An audit of paediatric hip dysplasia surgeries at CHI hospitals found that hundreds of children operated on between 2021 and 2023 did not meet the threshold for the procedure. It has been discovered that almost 80% of those operated on at NOHC, and 60% of those at Temple Street, did not meet the threshold for surgery in that timeframe. In its report, it stated that the first step should be to recall all 497 cases that underwent pelvic osteotomy at the hospitals between 2021 to 2023. They should undergo a standardised independent clinical review and radiological assessment, the report added. 'X-rays should then be reviewed, with the history obtained, by appropriately experienced paediatric orthopaedic surgeons from a different institution to NOHC or TSH,' it said. 'Follow-up with a suitably experienced and independent paediatric orthopaedic surgeon may be required in some cases.' According to the audit, 85 surgeries performed at Temple Street were examined, of which 51 did not meet the clinical criteria for surgery. In Cappagh, 70 pelvic surgeries were examined, and 55 did not meet the criteria, meaning almost 80% of procedures were not necessary. The audit examined 147 cases at both hospitals as well as Crumlin hospital, and involved 14 surgeons. The report found that the threshold for procedures varied between Crumlin, Temple Street and Cappagh hospitals. The group of affected patients will be contacted directly to explain what this means and the next steps for them, it said. The CEO of Children's Health Ireland, Lucy Nugent, said: 'The care and wellbeing of children is our absolute priority in Children's Health Ireland, and I am sorry that impacted families were not offered one consistent and excellent standard of care across our DDH (Developmental Dysplasia of the Hip) service. 'I do not underestimate the stress and anxiety that families are rightfully feeling throughout this audit process. 'To one family in particular, whose child experienced complications during their care in Children's Health Ireland, I extend my heartfelt apology that we have let you down. 'I would like to give my assurance to all of the families affected, that they will be directly supported and are being contacted with follow-up information and the next steps. 'We are currently standardising care across all CHI sites, so all children receive the same high-quality treatment no matter where they are seen. 'Also, it is important that we now act swiftly to review DDH surgery patients to enable us to answer outstanding questions raised by this audit. This will be done openly and transparently.' The CEO of NOHC, Angela Lee, said: 'The National Orthopaedic Hospital Cappagh apologises for the distress that today's published report may understandably cause to children who have had surgery in NOHC and to their parents. 'In recent years, Cappagh has worked with Children's Health Ireland to improve children's access to planned paediatric orthopaedic surgery. 'We are committed to implementing the audit recommendations. Some changes are already under way, with others planned and we will be communicating with all parents/guardians accordingly in the coming days.' Minister for Health Jennifer Carroll McNeill said in a statement: 'I know that parents and young people themselves will have many questions when they read the report and that the findings of this report will lead to worry and uncertainty for them. 'In responding to this report, I am thinking first and foremost of the impact a surgery has on a child. I am also deeply aware of the worry that parents will face today and this is something that is sitting with me all the time. 'My immediate priority is to ensure that there is clinical follow-up and care for patients who have undergone pelvic osteotomy surgery. This follow-up will be in accordance with best practice and the recommendations of the report.'
