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

At the outset, I also extend my deepest sympathies on the floor of the House to the family, friends and colleagues of Garda Kevin Flatley. Our thoughts and prayers are particularly with his wife Una and his daughters Aoife and Erin. He died in the line of duty, which is a reminder to us of the dangers that members of An Garda Síochána go through day after day as part of their mission to keep us all safe and prevent crime. He was an outstanding community person, as many gardaí are. They not only give duty in the line of service but, outside of their duties as members of An Garda Síochána, they are pillars within our communities, helping sporting organisations, in this case with Kevin helping O'Dwyer's GAA club. We extend our sympathies to the broader force and to all members of An Garda Síochána at what it is a very difficult and traumatic time for them, and a huge blow to the force.

Regarding the clinical audit that is being conducted in respect of developmental dysplasia, in the first instance, it has to be said that there is a lot of anxiety and concern. A lot of parents would be worried because for a child to go through an operation or surgery is very traumatic for a child and very traumatic for the parents. Anything we do here must be done with that in mind, so we are very conscious of the anxiety that can be added to or created by anything we say or by piecemeal information or a drip-feed in respect of this issue.

The Minister has taken the correct decision in terms of establishing a clinical audit by an external international expert on surgery for children with developmental dysplasia of the hip across the CHI and the National Orthopaedic Hospital in Cappagh. As the Deputy knows, that audit was carried out after concerns were raised that different standards and surgical practices were being used for DDH at CHI Temple Street and Cappagh.

The purpose was to assess whether the standards and surgical practice used in CHI and Cappagh were in keeping with international standards of practice. Concerns had initially been raised under a protected disclosure in September 2023 and the Department was notified on 9 May 2024. There was some delay to the starting of the audit as the surgeon who had originally agreed to carry out the audit was no longer able to do so. Therefore, it was necessary to secure the expertise of another paediatric surgeon.

The clinical audit was conducted on a random anonymised sample of patients aged one to seven years of age who had these procedures between 2021 and 2023 in CHI and Cappagh. The audit process is now at a very advanced stage. It is understood the audit author has received final feedback and fact checking from the clinicians to whom the draft report was circulated. We all know this is standard procedure in respect of audits of this kind. We do not have a final timeline from the HSE or CHI for when the report will be fully complete and provided to the Minister. Pending completion of the audit report, and as a patient safety precaution, all DDH cases are now being reviewed by a single team of clinicians from CHI and Cappagh before any decision for surgery is made. This process has been in place since March 2025.

Deputy McDonald is correct that an action plan is currently being drafted in advance of the final audit report. This plan includes the identification of groups of patients not included in the audit sample but who may be affected by any finding of the audit. Plans are being put in place for patient follow-up in line with good practice and will, of course, consider any recommendation with regard to clinical follow-up from the final report.

CHI and Cappagh have issued letters in recent weeks to families and patients who have had a hip dysplasia procedure since 2010 to provide reassurance and information about the audit and to ensure all potential cases. Those letters went out after media reporting of a draft audit report. It was found necessary after that to communicate to parents as a result of reports of a draft report. The Minister cannot comment on it because she has not received a report. It is critical that the Minister would get a report.

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