THE GOVERNMENT HAS accepted the recommendation to carry out a commission of investigation into spinal and orthopaedic care by Children’s Health Ireland (CHI) rather than a public inquiry.

The recommendation was made as part of the final report of the CHI Inquiry Scoping Exercise, which was published today by Minister for Health Jennifer Carroll MacNeill.

The 134-page report, undertaken by Senior Counsel (SC) Remy Farrell, recommends a commission of inquiry rather than a tribunal of inquiry.

His recommendation comes following a process which began in March of this year and involved gathering documents from CHI and the HSE and engaging with stakeholders, including patient advocacy groups, affected parents, clinicians and representatives of both the HSE and CHI.

The scoping exercise sought to define the parameters that would be put in place for an inquiry. One of the core questions Farrell had to answer was whether the inquiry should be a commission of investigation or a tribunal of investigation.

The main difference between the two is that the work of a tribunal generally occurs by default in public whilst commissions operate in private.

Because of this, tribunals are generally seen as more adversarial in nature.

Both forms of inquiry have the same powers to compel witnesses and documentation and have similar powers against self-incrimination and the non-use of material in subsequent criminal proceedings. Both also result in the publication of a final report. 

In explaining his decision to recommend a commission of investigation rather than a tribunal, Farrell noted that in general, there is a view that commissions tend to be “somewhat more efficient in terms of time and resources”.

He said that given the fact that the inquiry involves the medical care of children, there is a risk the children concerned may be identifiable by reference to the nature of their medical conditions or other details.

He also noted that a commission is more likely to encourage broader participation, particularly from families and children who might otherwise be reluctant to participate in
a process that takes place primarily in public.

Furthermore, he said a commission is somewhat less likely to impact on the time required by clinicians and other staff for participation, “thereby lessening the ongoing
delivery of care”.

He said it was his view that the balance lies “quite decisively” in favour of a commission. 

Discontent

During the process of the scoping exercise, a number of patient advocacy groups withdrew from it over discontent that they were not granted access to all the same documentation from the HSE and CHI that was furnished to Farrell for the purpose of the scoping exercise. 

Solicitors representing the parents of the late Harvey Morrison Sherratt also informed Farrell that they would not be making detailed submissions in circumstances where there was a pending incident review and coroner’s inquest underway in respect of the circumstances surrounding Harvey’s death. 

Reacting to today’s news, Social Democrats health spokesperson Pádraig Rice urged the health minister to sit down around a table with affected parents before the terms of reference for the inquiry are confirmed. 

“The families have made it clear they do not want an inquiry held behind closed doors, and proposed limits on the scope of this inquiry have caused them serious alarm.

“Instead of genuinely working with families and providing them with an opportunity to meaningfully shape the inquiry, they have effectively been told what will happen. And it appears that what will happen falls far short of what they want, and need, from any public inquiry,” he said.

Work on the scoping exercise began on 3 March 2026 when Farrell was appointed by the health minister. It was initially envisaged that this scoping exercise would be completed within 16 weeks. 

The scoping exercise to set out what the inquiry would look like came following meetings between the government and patient advocacy groups.

The government agreed on 18 November 2025 to a statutory inquiry into spina bifida and complex scoliosis.

Welcoming the publication of the scoping exercise’s final report today, Carroll MacNeill said she is grateful to the parents, families and advocacy groups for their collaboration with Farrell throughout the process.

“The difficult experiences of families are evident throughout the report, and their insights have informed its recommendations…The Government has accepted the report’s recommendations in full,” she said.

Carroll MacNeill said officials in the Department of Health will now work with the Office of the Attorney General to begin drafting the Terms of Reference for the proposed Commission of Investigation. 

In a statement this afternoon, CHI said it will work with the government to “ensure an efficient, fair and child-centred outcome”.

“CHI has accepted the findings of previous reviews and audits, made significant changes and remains committed to transparency, accountability and continuous improvement.

“We will be seeking more information on the terms of reference, planned processes, procedures and timelines so that staff can be prepared and adequately supported during this process while also minimising disruption to the delivery of clinical services.

“CHI acknowledges the courage of the children, young people and families who have shared their experiences. Their voices must be heard, and where failings have been identified, they will be acknowledged, addressed and learned from,” the statement said.