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Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: That is right. Representatives of CHI will appear before the committee on Thursday. The advice I have is that Crumlin hospital took it upon itself to do a similar review on the basis that concerns had been raised in Temple Street. The advice I have is that it was not based on concerns being raised and that it did not find an unexpected level of complication.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I believe it was commissioned around September of last year and I believe 11 cases were involved.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: This is one of the core questions we need to get to the bottom of. I am deeply frustrated that I do not yet have a satisfactory answer because I have posed this question to Children's Health Ireland on more than one occasion, as have my officials. We know there has been a very large investment and a really fantastic clinical workforce has turned that money into far more surgeries happening....

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: It will be part of Mr. Nayagam's review. The third objective is "To assess the governance of the Paediatric Orthopaedic Surgery Service and to make findings, [that is right across the board] and to make any necessary recommendations in regard to improvement in governance including quality, safety, outcomes and performance metrics." Dr. Colm Henry and I have spoken directly on this. I have...

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I will double check the exact details, but my understanding is that it was paused last November. It is still paused and the last kyphectomy procedure happened in the middle of last year, perhaps in July 2022. It was officially paused in around November, but we can get the Deputy the exact dates.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I will get the Deputy exact details. I do not have it in terms of individual surgeries that are being recommended for particular patients. However, the reality is that we have two surgeons who do complex spina bifida care and it is done in Temple Street. One of those surgeons is currently not doing those surgeries. Will that have an effect and is it already having an effect on the time...

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: Yes, I have. The clinical director is very clear that in CHI and in Temple Street additional communications and additional protocols were put in place. As they would say very clearly, there are already numerous protocols in place in every operating theatre in the country to ensure things like this do not happen.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: It is an important question. It is not a short answer. The Deputy is referring to a number of different children across a number of different surgeries, several of which have been identified as serious patient safety incidents and others which have not. I might come back to Deputy Lawless and to colleagues in writing to ensure that there is a detailed response to this.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I thank the Deputy for his question. I note the CHI report states July and I believe it is November for the two patient safety incidents. I will check the exact timing but the process which will have been followed is that when those incidents were notified, the Department will have been notified. Importantly, I have also checked that the parents were followed up, close to when those...

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: No, I did not. As per the opening speech, we would be notified of perhaps 20 or 30 of these incidents in a typical year. We deal with them, the Department engages with the HSE, I am updated on them, and then I interact as appropriate.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: There would have been communication between my Department and his Department previously rather than-----

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I will check exactly when that was but the Deputy may understand that there is official communication. That is how I am informed and how the Taoiseach is informed. The Taoiseach and I spoke in detail about this last week but there was previous communication in August, and, potentially, before that with his officials and his Department.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I believe the exact date when I was informed was 4 August.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: That would have been communication with the Taoiseach's Department through July and August and I can check as to exactly what communication may have included information on the springs.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: The short answer is "Yes". It is also important to say that the reviewer will meet directly with the families and groups. In fact, it is specifically within the terms of reference which includes consultations with patients' families and staff. The intention was that Mr. Nayagam would meet with them and he has full discretion within the current terms to adjust them according to what he...

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: In the spirit of questions and answers and I appreciate that the Deputy has a question, so I will be short. I hear and agree with the Deputy and say that should have happened but it is important to state that it was and remains the intention that would happen, but that it would happen directly with the reviewer. In addition to that, yes, it should have happened with the Department and with...

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I thank the Deputy. I will be able to provide colleagues with a list of the current workforce and consultants across CHI. As colleagues will be aware, we have paediatric orthopaedic consultants who work across numerous sites, including Temple Street, Crumlin and Cappagh hospitals. There is also some activity for which Blackrock Clinic is used. There are various surgeons involved there....

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: We do. They are published.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: Yes. They were published last week.

Children's Health Ireland - Patient safety concerns and reviews in paediatric orthopaedic surgical services: Statements, Questions and Answers (26 Sep 2023)

Stephen Donnelly: I want to start by acknowledging the intense distress and anxiety this whole episode is causing to the patients themselves involved in these reviews. These are girls and boys, young women and men, and, of course, their parents and families. These young people and families already have so much to deal with as regards their underlying medical conditions, and I am acutely aware, as I know all...