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SINN FÉIN LEADER Mary Lou McDonald has said there is “profound dysfunction within the fabric” of Children’s Health Ireland (CHI).
The Chair of CHI, Dr Jim Browne, resigned today after a Hiqa report on the use of unlicensed springs in surgeries at Temple Street Children’s Hospital in Dublin.
It’s led to calls for an investigation into governance at CHI.
The Hiqa report said the use of the non-CE-marked springs formed part of “a well-intentioned but ill-considered effort to provide an alternative approach to surgical treatment, involving a single operation, for a number of children with life-limiting conditions” who had otherwise been facing multiple operations, each with its associated risks.
Hiqa also found that governance changes within CHI meant that a number of policies and safety checks “were not properly applied” in treating the children affected, “resulting in the springs being used inappropriately”.
The review makes 19 recommendations, including an organisation-wide review of corporate and clinical governance at CHI “to ensure clarity and effective assurance of safe, quality care”.
Health Minister Jennifer Carroll MacNeill said she was “shocked by every element of the report”.
She said that following Browne’s resignation, she would “reflect on the board” and is “looking at governance” within CHI.
Carroll MacNeill added that people “who see things that are clearly wrong, must step forward and say them”.
Speaking during Leaders’ Questions in the Dáil, McDonald said the line from the Hiqa report that “really sums up the governance failures at CHI” is the following: “Children were not protected from the risk of harm.”
She described the report as a “damning litany of failure”.
“Failure of governance, failure of management, abject failure by government to act and ministers to do their job.”
She added that CHI “is not fit-for-purpose and they were allowed to carry on in that way”.
“Different rules in different hospitals, separate procurement processes across each hospital, no proper checks or oversight of process, parents kept in the dark about the true nature of the surgeries carried out on their children.”
McDonald said these failures “were known for years” and were known to the government “and yet nothing was done”.
“There has to be accountability all round, and there must be political accountability.
“These failures span seven years, two health ministers and were raised many times at the very highest level and raised here in the Dáil.”
She added: “We’re now witnessing this pattern of behaviour, dysfunction and scandal repeated again with regards to unnecessary hip surgeries on children.”
A leaked draft report published by The Ditch last month into hip surgeries carried out on children found that 79% of those operated on at Cappagh and 60% of those at Temple Street did not meet the threshold for surgery.
McDonald asked Taoiseach Micheál Martin if he had confidence in the board and executive of CHI.
Martin responded that “it is beyond comprehension that springs that are not permitted were used in surgery”.
He noted that the Hiqa inquiry was established following a parliamentary question from People Before Profit TD Paul Murphy.
Martin then addressed McDonald and said: “I understand where the deputy is going in terms of wanting to sort of say it’s ultimately the government’s fault.
“There’s a limit to what anyone in this house can do in terms of how people conduct procedures in operating theatres.”
He added that all 19 recommendations will be implemented and evaluated.
McDonald however asked if the rest of the CHI board needed to follow Dr Jim Browne in resigning.
Martin remarked that “too much in this house, we immediately go to the political domain”.
“What happened shouldn’t have happened. There was an individual decision taken to use springs that should not have been used on any child.
“We’re the biggest medical device manufacturer in Europe – the idea that you would use springs outside of that entire protection framework is beyond belief and responsibility.
“Responsibility, in my view, lies with the individual in the first instance.”
Meanwhile, People Before Profit TD Paul Murphy remarked that it is almost two years since he first asked if all implants used in spinal surgery for patients with spina bifida and spinal muscular atrophy across Temple Street and Crumlin hospitals were appropriately licensed.
“The CHI answered that to the best of their knowledge, it was standard practice that they are approved and licensed appropriately for this purpose,” said Murphy.
He added: “The whistleblower was able to confirm at that time that this was not the case.
“The surgeon in question was buying metal springs off the internet that were not designed for any medical purpose, and inserting them into vulnerable children.
“This has been a major failure of governance at Children’s Hospital Ireland and another failure of children by this State.”
He has called for an independent public inquiry to investigate how this happened and added: “I want to emphasise that this inquiry should include adult as well as child patients of this surgeon.
Elsewhere, Social Democrats TD Pádraig Rice, the party’s spokesperson on health, remarked that “these springs should have never even made it into the surgical theatre, let alone the bodies of young children”.
He added: “According to Hiqa’s findings, the non-alloyed spring steel used in these surgeries are ‘known to corrode in the presence of moisture and there is very limited information available on its use or the risks of its use for implantation’.
“Shockingly, the arrangements in place for the use of medical devices and surgical implants were not standardised across CHI, and where arrangements existed, there were unclear lines of reporting and accountability.”
Rice added that the 19 recommendations set out in HIQA’s report “must now be acted on by CHI and the HSE, with clear timelines for their implementation”.
“We have now seen multiple controversies involving CHI, including long waiting times for scoliosis surgery; concerns over how money earmarked for scoliosis surgery was spent elsewhere; and a lack of preparedness for the opening of the new children’s hospital,” said Rice.
“There are now serious questions over governance at CHI and their capacity to effectively manage the National Children’s Hospital.
“The Oireachtas Health Committee must be urgently established so that CHI can be brought before it to answer questions about their repeated failures of governance and care, as well as their readiness to operate the new hospital.”
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