Micheál Martin (Cork South-Central, Fianna Fail) | Oireachtas source

It is very traumatic for any young child to go through surgery, irrespective of the gravity of that surgery. Equally, it is very traumatic experience for parents. In that context, to have a clinical audit established at CHI and Cappagh hospitals on the surgical management of children with the condition known as developmental dysplasia of the hip is deeply traumatic and compounds the original trauma. It is extremely worrying for patients and will lead to anger if it transpires that operations were carried out that were not required at all.

People should remember that, first and foremost, this is a clinical issue insofar as the decision to take the step of surgery is a clinical one. It is predetermined and it should be done through multidisciplinary teams that decide whether a child needs surgery for a specific condition. It is extremely serious that the assertion is that quite a number of operations were carried out unnecessarily, notwithstanding the fact that we are talking about clinicians involved in surgery of this kind.

A clinical audit is being conducted by an external international expert on surgery for children with developmental dysplasia of the hip across CHI hospitals and at the National Orthopaedic Hospital Cappagh. I believe the Deputy knows the condition. It is a problem with the way a baby’s hip joint forms, and some children with it may require surgery. The purpose of the audit is to establish that surgical practice was in line with international standards and practices. The audit is close to its final stages. It makes sense for us to await the completion of the audit in order that we will have an informed, evidenced-based approach to the issue.

Letters are being issued to the families by CHI and Cappagh hospitals, and they will be writing to them to provide further information in respect of this. I expect the details of the audit to be published and fully shared with the parents before publication.

My understanding is that concerns relating to different thresholds of surgery being applied in CHI hospitals and National Orthopaedic Hospital Cappagh were initially raised internally in CHI under protected disclosure arrangements in September 2023. The Department of Health was notified about this matter on 9 May 2024.

The audit process, as I have said, is at an advanced stage with clinicians to provide feedback on the draft report to the expert author by Friday, 21 March. Patient safety precautions are being put in place and a multi-disciplinary team is looking at all of this in a comprehensive way.

This is deeply worrying for the patients. We have to wait for the completion of the audit and the presentation of the findings to the parents, and then take what action is required also. It goes to the very heart of the clinical practice and standards that applied.

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