Peter Roche (Galway East, Fine Gael)

The Minister has inherited quite a difficult situation. I do not doubt her response, her hands-on approach and the swift action that she has taken. I read in a report that she means business, and rightly so.

It is shameful that we have to be talking about this kind of a calamity happening in modern-day medicine. It is hard to believe. Sitting at home listening to the news reports, I found myself saying "Not again." It beggars belief that this is happening in this day and age. However, we are where we are. I thank the whistleblower. Great credit has to be given to the person who felt the need to highlight this issue. We do not want to hear about it, but it is a reality. The fact that it is a reality means it needs to be dealt with, and it has been entrusted in the good Minister to do that. When we take our most cherished children to the hospital for care, we expect that they are in a safe place. We certainly expect that they will be cared for in the trust of the professionals caring for them, confident in the knowledge that every decision is grounded in evidence, compassion and accountability.

The findings of the CHI audit raise deep and troubling questions about whether that trust was upheld. We have also heard that nearly all surgeries reviewed in Crumlin hospital were found to have been appropriately selected for surgery based on current international standards, which is good. At Temple Street and Cappagh, however, the audit raised serious "concerns" about decision-making, where a significant number of procedures were carried out without meeting the acceptable clinical criteria, including surgeries on children with a stable hip and no prior treatment for DDH. Families are rightly being contacted on this issue because fundamental questions have been raised. The questions we all ask are: how did this happen?; why was it allowed to happen?; where were the checks and the balances?: why was the governance so weak? and, most importantly, how can we ensure that there is no repeat of it across any sector? There is no question of clinical variation. As the report makes clear, the scale of unjustified procedures cannot be explained by differences in judgment alone.

I welcome that these patients are being recalled for review and that the HSE is establishing, under the Minister's watch, an independent expert panel. That is really welcome and reassures me that we are responding to the crisis. This needs to be done not only for the families affected, but because public confidence in our health service needs to be restored. Most importantly, all future DDH surgery decisions will be consistent, evidence-based and focused solely on the best interest of the child. This is where governance must deliver, not as an abstract policy, but in real clinical decisions with real positives for real people. When governance fails, the patient pays the price. It must not happen again. We owe these families a lot of honesty, respect and, of course, accountability. As a member of the health committee, Deputy Rice, our Chair, has referred to the fact that we will be hearing lots more about this. It behoves us to respond in a professional and dignified way in terms of the way that we deal with these discussions.

There have been a lot of contributions. Many people and Members of this House have suggested that they know some of these families. I am no different; I know one family. That brings the whole thing closer to home. I commend the Minister on her swift action. We look forward to the findings of the independent review that will establish whether the surgeries carried out were necessary. That is most welcome. As I said earlier, we need to give reassurance to the general public.

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