Paul Murphy (Dublin South West, Solidarity) | Oireachtas source

What has happened in Temple Street is the abuse of vulnerable children. That abuse may have been motivated by a doctor or doctors who thought they knew best, were doing the best for the children and did not need to obey the rules. It may have been motivated by a hunt to maximise income through private health insurance. Regardless of the reason, it is abuse by individual doctors, such as Connor Green, who inserted the three metal springs and who also faces other allegations of malpractice. It is also abuse by individual doctors and individual wrongdoing that went undetected by the system. If not for the whistleblower, and the freedom of information, FOI, requests and parliamentary questions prompted by the whistleblower, we would not have had the internal review, the Boston review, the HIQA report or the Nayagam report that is due to the Irish Medical Council. That is the scariest part of all of this. If not for a brave whistleblower, springs could still be inserted in children today.

There are real cultural and governance issues in respect of the fact this was not spotted. One point made to me is that the CHI clinical director model means that one person sits over 12 specialties and is unable to keep an eye on what is happening. We should not treat the issue of unnecessary osteotomies on a massive and gross scale and unnecessary operations for hip dysplasia as separate issues to the malpractice of Connor Green. It was part of the same culture whereby there was bullying and intimidation, and where no one at Temple Street felt able to shout "Stop", or ask, "What is that spring doing in that child?" or, "Why are we having all these operations on children who clearly do not need them?" It is incredible.

The draft report suggests that 80% of hip operations at CHI were unnecessary, with the rate at 60% for Cappagh hospital. What does that look like for the families? I met Louise and Colin the week before last. They were in Temple Street with their daughter Emilia. Originally, there was a possibility that she would need an osteotomy on one hip. Thankfully, they went to another doctor at the hospital who told them it should be fine and that Emilia did not need such an operation. They then went to a particular doctor, whom I will not name at this stage, who said that Emilia definitely needed an osteotomy on both hips. The mother was uneasy with the manner of the doctor. She was uneasy with how eager he was to do the operation. She felt this was not right but was in a situation whereby a doctor was telling her that she must do something. She was not able to bring her daughter to the hospital that day. She blames herself, when she should not blame herself at all.

Afterwards, Emilia lost weeks of playschool. She was six before she could walk properly. The operation happened in 2018. Emilia was the slowest to do a cartwheel and the last to ride a bike. Until she was seven and a half years old, she would say her legs were sore. She was discharged at six years of age. She had been told she would have annual check-ups until she was 16 but was suddenly discharged when she was six. Just a few months ago, when Emilia was nine, Louise was watching a debate on Leaders' Questions and asked Emilia if she still had any problems with her hips. Emilia told her that she only gets pain when she walks up the stairs.

The scariest part of the story is not what happened to Emilia. It is that Louise's second daughter, Hannah, had an eye condition at the time. When the hospital was discharging Emilia, the doctor in question said he would like to check Hannah. The mother said that was not necessary because Hannah had been checked in the Coombe but the doctor was absolutely obsessed. He checked, logged into the CHI database and looked at the scan. He said he was not happy with the situation and suggested that Hannah needed both hips done. Louise went back to the Coombe, where the doctor said that was a load of nonsense and that Hannah did not need either of her hips done. Thankfully, Hannah did not get the operations.

Emilia's case is not included in the audit because it happened in 2018 and the audit runs from 2021 to 2023. Every hip operation will need to be looked at in order for these parents to get support. The Nayagam report is going to be damning for Connor Green. Every surgery that Connor Green did, including on adults, needs to be looked at. I know of a horrifying case of an adult who was pressured into what seems to have been an inappropriate surgery. We need to broaden our examination as well as having a public inquiry.

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