Ruairí Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context

11. To ask the Minister for Health the mechanism by which parents whose children were and are deemed to need hip dysplasia surgery at CHI hospitals at Temple Street and Cappagh will be able to get independent second opinions by experts of their choosing paid for by the HSE; and if she will make a statement on the matter. [33749/25]

Ruairí Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context

I want to ask the Minister the mechanism by which parents whose children are deemed to need hip dysplasia surgery at CHI hospitals such as Temple Street and Cappagh will be able to get independent second opinions by experts of their choosing, paid for by the HSE? I have spoken to the Minister on this previously and I believe she was working with Bernard Gloster on finding a solution to this issue, which is absolutely necessary.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

I agree completely with the Deputy. However, my immediate priority is to ensure that there is clinical follow-up and care for patients who have undergone pelvic osteotomy surgery in accordance with the recommendations of the Thomas audit report. I am very aware that there are families around Ireland who are receiving letters and follow-up to say that surgery was not necessary on their child. I cannot imagine the distress that those families experience when they receive that sort of communication. I have spoken to families who are having that experience and it is so utterly distressing for them.

Clinical follow-up to skeletal maturity for children in CHI Crumlin, CHI Temple Street and the National Orthopaedic Hospital Cappagh, NOHC, is already under way for patients. These children have been identified and categorised by age, with a proportion of them being close to skeletal maturity and likely to need just one appointment. The clinic is structured as a one-stop multidisciplinary team model for assessment, and that includes consultation with a doctor, a physiotherapy assessment, an X-ray, if clinically indicated, and immediate documentation of findings. After this, patients enter the recommended normal follow-up process.

As of Monday, 23 June 2025, 115 appointments have been offered to CHI and NOHC patients. A total of 86 patients have been booked and 71 patients have been seen so far. Patients who request attendance at another hospital or with another consultant will have their request facilitated by CHI. It is important to say that the consultant who did the surgery is not the one who is doing the review, in the clinical follow-up. I will get to the expert review as well. I just want to make sure that this is on the record.

In relation to the retrospective reviews of cases, which is the second process, to determine the indications for surgery and whether they were warranted, the HSE is establishing a separate process, involving external experts. Professor Deborah McNamara, the president of RCSI, has agreed to assist the HSE in establishing the expert panel and terms of reference.

I have more information for the Deputy on that.

Ruairí Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context

I do not think anyone will disagree with the assertion that we have had an absolute disaster and failure around children's care. Many have gone through operations they did not need. We need to deal with those children and make sure they are reviewed correctly and properly from a medical point of view and that they get the correct pathways afterwards.

I bring it up and brought it up before because I am thinking of a case in my constituency. A mam has three kids, two of whom had the operation. She has the question mark over their care, whether they needed the operations and all those terrible questions she is dealing with. She has another child who was to have an operation. We are talking about osteotomies. Her issue previously was it was delayed. Most people would believe what a medical expert tells them about whether an operation is needed.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
Link to this: Individually | In context

I thank my colleague for tabling this question. We recently had CHI and the HSE in the committee on this issue. In the Gallery were representatives of the hip dysplasia advocacy group. Afterwards, I met one of those dads in the car park, a young dad and an awful nice guy. He was in a ball of tears. I do not know this man. I had never met him before and he had never met me. That is the level of distress these parents are under - crying to a perfect stranger in the car park of Leinster House. It is not something I ever thought I would see or something I ever want to see again.

I ask the Minister for two things. First, will she meet with the hip dysplasia advocacy group? Second, the HSE gave me a commitment that day to make all supports available to the parents. I ask that each and every one of them be offered psychology or counselling supports, given the level of distress these parents are under.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

My practice, as much as I possibly can, is to meet people. Like Deputy Clarke, I have met parents and seen the distress. I have parents in my constituency in this situation. There is no difference between our experiences of this. I cannot believe the distress being experienced by the parents of the 71 children. We are already identifying children. Parents are being told through this initial clinical follow-up that their child did not need this.

I will now update the Deputies on the expert review process to follow. We are in the process of establishing that panel. It is not complete but there are a number of experts from Canada and the United Kingdom. It is not surgeons within the system; it is very different. The clinical review follow-up, the first process, is expected to take about six months and for the secondary review panel, the independent expert one, it will take until September for the establishment of the team. We have four at the moment and there are a number of others to come. They need to agree the terms of reference; it is not for us to impose the terms of reference on them. They can assess each case as appropriate once they have begun.

Ruairí Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context

I appreciate the timelines. The clinical review is six months and the Minister is saying it is September for the expert review process. The terms of reference are not set. We would like to think this will deal with the issue of the considerable timeline that would need to be taken into account, the huge number of cases and the disparity. In the case of my constituent, can we find a process to ensure she can get the follow-up care for her daughters and can get an independent review she can trust in relation to her other child, who has been told she needs surgery? Trust is at an all-time low in relation to CHI. We need this work done as soon as possible. I ask the Minister to take into account many of the cases we have brought forward, particularly the parents who got reviews and, on that basis, did not go ahead with operations. I brought an issue like that to the Minister previously.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

I do not know the exact details of the Deputy's constituent's case but for any child now indicated for surgery, the assessment is done in a very different way from how it happened before. Any such assessment is done by a multidisciplinary team, including a doctor. It is a cross-site piece of work including a physiotherapist assessment. It is not, as had been the case, that an individual consultant makes decisions in his or her own bubble. This is a multidisciplinary team. The Deputy's constituent or any Deputy's constituent who has a child indicated for surgery can, depending on the timing, get the assessment through the multidisciplinary team. It is very different from what was there before. I hope that will give her more confidence where she has questions relating to her child.

I agree with Deputy Clarke on counselling and psychological supports. Parents who take the advice of clinicians do so in the best interests of their child and now feel they have done something wrong in following that advice. It is a devastating thing to happen to a parent who is only trying to be a good parent and take the right decisions. They need support as much as their children do. I totally recognise that.