Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

At the outset, I extend my condolences to the family of Dollceanna Carter. I offer my sympathies to all of the families impacted by this saga. It is a national scandal and a major issue that needs to be addressed. We need a timely response to it. It cannot just be another example of setting up a review and kicking it down the road, but my fear is that that is what will happen.

The Minister and the Minister of State spoke about the importance of having an appropriate response when things go wrong and of ensuring that that response is honest, open and transparent. There should be full disclosure and a candid response, but I am concerned that we have not got that. The first I heard of this situation was Monday morning last week when the article in The Ditchwas brought to my attention. At around lunchtime, we got further information from the HSE. If it had not been for the article in The Ditch, when would we have heard about all of this?

I also have a concern about the response to that and how this was announced publicly last Monday. It was very much announced on the basis that there was a single issue and it was all about an individual consultant. That is how the HSE press statement was framed and how a spokesperson for HSE framed it - that this whole thing was about an individual consultant.

We were also told that the two reviews that had been completed - internal and external - would be published that day. It turned out that they were not published that day. In fact, a HSE report on the two reviews was published that day. Essentially, that filtered the reviews. When I and others called for those reviews to be published, we were told they could not be published because of confidentiality and due to the fact that people who participated in them had been assured of confidentiality. Of course, that was not the case. Further to political pressure being applied throughout Monday and Tuesday, finally, on Wednesday, the two reviews were published. I have big concerns about the handling of this issue at official level, how it came to be announced and the framing of it.

When we did eventually get to see the two reviews - I do not know who carried out the internal review but it was basically a statistical review. The external review did not refer to any individual consultant, which is notable. It made 50 recommendations. It did not outline problems that were identified but one could read between the lines from the 50 recommendations about where the problems were within Temple Street. Pretty basic things were identified that needed to be addressed, such as the need for a clinical speciality lead for orthopaedics and that the operating theatre governance committee needed to be put in place. Why was that not there already? Another was the need to develop a quality improvement team to strengthen a quality improvement programme and to establish a culture of high reliability that demonstrates consistent excellence. One would have expected these things to exist already. Another was the need for evidence-based clinical guidelines and checklists. All of these things relate to the operation and management of Temple Street but there is no talk about any of this in the official response to this issue. Clearly, it was a much wider issue than one individual consultant. That is why concerns are being expressed that there is an element of scapegoating going on. When will the Minister tell us what Temple Street is doing in relation to those pretty severe implied criticisms and clear recommendations about the functioning of that hospital? Has Temple Street management taken on those? Will it respond to them?

There have been already three reviews, none of which was published. Now, there are another two, so there are five reviews. This latest fifth review may potentially take up to a year to complete. When will we know the facts of this and when will action be taken? In the meantime, the reaction of parents and advocacy groups is very understandable. They do not know where they stand. They are in a limbo at the moment. They do not know if all of the surgeries have been stopped in Temple Street, if things are safe or not or if CHI has the ICU beds to carry out surgeries elsewhere if they are stopped in Temple Street. There is a need for an interim plan. It is important that we find out what happened in the past and that there is a thorough review but what is going to happen now? Parents were expecting their children to have their surgeries today, next week or next month. What is happening to those? The Minister needs to produce an interim strategy or an interim plan in relation to that. It is not just those children who had spinal surgery. There were other surgeries carried out by the surgeon in question. What about the concerns of those families? When will they be addressed? There are adult patients of that surgeon as well who do not know where they stand. I welcome that the Taoiseach has now agreed to meet the advocacy groups but it is absolutely critical that they have a clear input into the terms of reference now. They know what happened in the past. They are now in a situation in which trust has broken down. The most important thing the Minister has to do is to restore that trust.

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