Micheál Martin (Cork South-Central, Fianna Fail)

Again, I reiterate that this is a shocking report into hip operations. For example, there is the variation between Crumlin at 98% that were clinically indicated - that has to be stressed - to only 60% in Temple Street and 21% in Cappagh. This variation alone, from an external independent author, sends all sorts of alarm bell ringing. We have to find out how that happened and why it happened. Why were children operated on who did not require any operation? It is incomprehensible and unethical. It is just unacceptable. We have to get to the bottom of this because it goes to the heart of trust and confidence in our health system and in clinical judgment and clinical performance. It goes to the heart of clinical performance, whether people like us saying it or not.

Equally, if we look at the report on the springs, I found it very difficult to comprehend how something that was not certified or CE standard was inserted into children. We get various communications, anonymously and so on, saying we misread it and we were too harsh on the individual consultant when we said certain things in the Dáil but it is a basic. We have a very sophisticated medical device industry in Ireland where the standards are the highest in the world. We produce hips in this country. We produce all sorts of orthopaedic products. Everything is about quality assurance and quality control, yet in one of our tertiary hospitals – I am sorry, but it is an orthopaedic hospital, not tertiary - springs were inserted into a child with no one making the assessment on whether they had gone through the proper process. It is incomprehensible this would happen.

To answer Deputy O'Callaghan's question, it does raise the most fundamental questions about the entire programme of clinical directorship and whether it is working, and it does need to be reviewed. The idea was a good idea. It is actually a good concept and a good idea but it does depend on everybody working as a team. We have had the dysplasia report on the hips. We are awaiting a further report on the operation of the paediatric spinal service, the Nayagam report. Now we have the internal enquiry that surfaced via the media, and which was not sent to the HSE or the Department from what we can establish and verify. Therefore, that report raises a series of issues also in terms of the governance question, safety questions, atmosphere and so on, which Deputy O'Callaghan has referenced.

Taking all of this in its totality, one has to state the obvious that we need to look fundamentally at the governance of CHI and we have to move quickly in the short term, as the Minister is, in ensuring two HSE board members are on the board but then, how do we evolve that further?

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