Darren O'Rourke (Meath East, Sinn Fein)
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85. To ask the Minister for Health for an update on the investigation into unnecessary hip surgeries at CHI; the supports available to those affected; and if she will make a statement on the matter. [51162/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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My immediate priority following the publication of the Thomas audit on 23 May 2025 was to ensure there was clinical follow-up and care for patients who had undergone pelvic osteotomy surgery. This is a once-off review to assess any complications that may exist and to determine the current clinical state. After this, patients then enter the recommended normal follow-up process. These multidisciplinary team, MDT, clinics have been under way since 6 June for clinical reviews of patients who had osteotomy surgery in CHI at Temple Street and Cappagh. As of Tuesday, 21 September, a total of 196 patients have had clinical reviews as part of the MDT clinics in both CHI and Cappagh.

In relation to retrospective reviews of cases to determine the indications for surgery, as the Deputy is aware, the HSE is establishing a separate process involving external experts. Work to establish that external expert panel is advancing. It is expected that panel will be established this month and the review of individual cases will commence in January 2026. These are international clinical experts. We are trying to establish them to have the availability to do the work here - it takes a little time simply to have their availability - and for them to agree a robust and scientific methodological framework for conducting the review, which will be designed by them between September and December this year, by which everything can be measured.

The HSE has also committed to the involvement of parents and patient advocates in the terms of reference for the review. We had a workshop to discuss the external expert panel with them on 14 August. A further workshop took place on 13 September, with a further workshop planned for today.

Separately, it is my intention to communicate with all of the parents who are not necessarily part of the advocacy group representing parents, recognising that they may not wish to be part of it but also to make sure they have the opportunity to feed into perspectives, should they wish.

Darren O'Rourke (Meath East, Sinn Fein)
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I thank the Minister for that update. I have a few follow-up questions. On the initial cohort of 196, does the Minister have an indicative timeline on when that full cohort might be completed? It was a significant number and in excess of 196. Is the Minister close to appointing a lead for the membership of the external review? We are only at the start of the month but there is keen interest in that. There was lots of disappointment that it has taken until January to get the review up and running. Is there a commitment that there will be a six-month timeframe for it to conclude its work?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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We are imminently close to appointing a lead. I would have preferred to be in a position to do that today, but I am not. It is imminent, essentially.

I appreciate what the Deputy said about January. It is for this group of experts to determine their process and not for me to step across that. I expect and hope it would be done within six months but, again, if independent clinical experts tell me differently, then I will take their clinical perspective on it, as I am sure the Deputy would. I remain committed to updating the House, when I have the information, at any stage.

I am sorry that I do not have a timeline for the complete group of patients, but I will look into that to see what is possible and come back to the Deputy. Again, it will be an estimated timeframe. I am somewhat pleased that close to 200 patients have had that clinical review. Of course, that has been prioritised for those who might be expected to have complications, as I understand it, but I will look at that further.

Darren O'Rourke (Meath East, Sinn Fein)
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I welcome that the Minister outlined a series of dates for engagement, including today. There is some emerging and serious concern about the scope and potential terms of reference for the external review. One area is how it will specifically relate to Crumlin hospital and surgeons operating there, as well as at Cork, Galway and elsewhere across the State and, related to that, how it will apply to children with complex additional comorbidities or needs. Will the Minister commit to ongoing engagement with advocacy groups and representatives on the development of those terms of reference?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Yes. We are having the third meeting today. I will meet the hip dysplasia advocacy group on Tuesday, 14 October in Leinster House. I will also make clear to all parents who may not wish to be part of an advocacy group, or be connected to that, I am here to hear from them at any stage as well.

It is also important to update the House that a meeting was held with the DDH advocacy group and the HSE on 24 September regarding mental health supports. It has been an enormously traumatic experience for many parents, as well as patients, to learn that surgery on their child may not have been necessary. A business case for funding all of the elements on this issue, including counselling, has been submitted as part of the Estimates process. I do not want to lose sight of that element of it too.