Erin McGreehan (Louth, Fianna Fail)

I welcome the opportunity to speak on this highly concerning matter, which has rocked many families across the country. The lack of any sort of organisation or accountability within CHI is a grave matter. This has rocked every parent and devastated the affected families again. It shakes public trust in our healthcare system to its foundations. What is happening in Children's Health Ireland at the minute can only be described as an extreme crisis. What was supposed to be a beacon of excellence for paediatric care is mired in dysfunction, delay and disillusionment resulting from a long list of mistakes. The further resignations from the board today are symptomatic of this.

The results of the recent audit into paediatric hip surgeries conducted by Children's Health Ireland and the National Orthopaedic Hospital Cappagh have exposed systematic failures. The findings of the audit are stark and beyond alarming. The majority of the pelvic osteotomy procedures carried out in CHI at Temple Street, 60%, and at the National Orthopaedic Hospital Cappagh, 79%, that were looked at did not meet the clinical indication of the agreed standard applied for the audit. The majority procedure looked at in Crumlin, 98%, did meet that clinical indication. The report further states that, while there is worldwide variability between surgeons, the variance identified in the audit cannot be accounted for by measurement error or observer variability alone. Surgeries being identified as having been carried out without sufficient clinical justification means that children underwent operations that were not only inappropriate, but potentially harmful.

This issue goes beyond medical error; it is an ethical failure and absolutely disgusting. If children undergo surgery that is not necessary, it is not a clinical misstep but an assault on their wee person, their health and their trust. To perform a procedure without just cause is an unconscionable violation. Where do families turn now that trust is gone? How can they place their children into the care of the same hospitals now? The health service has a lot of work to do. I hope this can be rectified but the appalling allegations will make it difficult.

I have spoken to the mothers of children who have had this surgery. They feel lost in bureaucracy and need to be given answers quickly and efficiently. There are children who are learning to walk again, who were discharged in agony and who were given incredibly strong drugs with no follow-up. It is incredibly upsetting. It is unbearable for me to think of the size of those wee people affected by it. Transparency, openness, flexibility and support for those families are necessary. A mother contacted me. She had immediately lost confidence because, when she called the phone line on Friday, the person who answered did not know the answers and the mother had to spell out "Cappagh" for the individual taking the notes. It does not instil confidence.

The Government must take immediate steps to address the shortcomings revealed in this audit. I welcome the clear plan outlined by the Minister. I hope there will be co-operation with her and with the follow-up. Transparency is needed, the families need answers and the children need proper trauma-informed follow-up care. If they do not wish to go back to the hospital where they were treated, they should be given financial support to travel for the follow-up care they require. I would find it very hard to place my child in the care of a hospital that had potentially butchered them.

I will highlight another point that I hope will be investigated. It has been touched on by speakers from across the House this evening. We need to check if there was a correlation between patients having private health insurance and having unnecessary surgeries. The families I have spoken to had private health insurance. They feel sick because they tried to do their best by their families in getting health insurance to get better care but may have been taken advantage of by a hospital seeking a quick buck.

The governance issues must be worked on in an incredibly efficient manner. Parents and children need to know everything about those children's time under the care of these hospitals. Care, support and alternative medical follow-up must be given. Accountability for all the wrongdoing must come without haste. Trust must be reinstated. I wish the Minister the very best of luck because she has hard work to do. The Government did not do this but it is the Government's job to clean it up.

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