Colm Burke (Cork North-Central, Fine Gael)

I thank the Minister for coming to the House to deal with this issue. This is a really difficult time for children but, in particular, for parents because children place their trust in their parents. The parents in this case placed their trust in the consultants and took their advice in coming to a decision about the best way of managing the medical care required.

Simon Thomas, who has been with the British Royal Hospital since 2007, carried out the review of operations performed in Crumlin, Temple Street and Cappagh. He found that Temple Street and Cappagh were doing something totally different from Crumlin. Crumlin seemed to have been doing far fewer operations, was not involved to the same extent and was following all the proper procedures in coming to decisions before performing these operations. The audit was carried out on pelvic osteotomy between January 2021 and December 2023. Paragraph 2.3 of the report states:

In many of the TSH [Temple Street] and NOHC [Cappagh] cases sampled, there was no record of closed or open hip reduction after delayed diagnosis, no record of either hip ever having been dislocated and often no history of treatment soon after birth by splint or brace for hip instability.

However, based on the surveys carried out, the evidence for the need for these surgeries did not appear to be there. It is accepted here in this House that the vast majority of consultants, junior doctors, nurses, care assistants and all the people who work in hospitals want to put their best foot forward and look after patients in the best possible way. The difficulty with this is the lack of trust that has been created as a result of what happened in this instance. It will take a huge amount of time and effort to build that trust back up. As a result, it is important that we do everything possible to make sure that there is full disclosure and that the families whose children have gone through unnecessary operations are given the necessary support.

We should have learned from history. A number of years ago, a consultant was doing unnecessary hysterectomies. That was identified in the past 15 years. We also had the whole issue with symphysiotomy, about which one person said, "He was sawing me in half." That was a grotesque way to carry out a medical procedure. It was in place of doing Caesarean sections.

While I am talking about Caesarean sections and the need for checks and balances, this is what I do not understand. I had understood that in all of our hospitals, regardless of the area of medicine, whether it is orthopaedics, maternity or paediatrics, there are checks and balances. Reviews are carried out in hospitals on a regular basis. That does not appear to be so in this case because these procedures were being carried out since 2010.

On maternity, the figures for one hospital in Ireland for February show that 73.5% of deliveries for first-time mothers were by way of Caesarean section. I would question the need for 73.5% of women to have Caesarean sections. It raises questions as to whether we are now taking decisions in order to fast-track what needs to be done. We need to set up a proper system right across the board in all of our hospitals in all of the different areas of medicine to make sure that reviews are carried out on a regular basis - not every year but at least once in every five years. That is something we need to look at.

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