I propose to take Questions Nos. 2402 to 2404, inclusive, together.
The Department initially became aware of concerns in the paediatric orthopaedic services at Children’s Health Ireland through a notification of Patient Safety Incident through the Department of Health and HSE Patient Safety Communications Protocol, part of the HSE Incident Management Framework, in November 2022.
This Incident Management Framework provides HSE staff with the required policies, procedures, and guidelines to manage and review incidents within the HSE. As part of this, the protocol exists and this protocol is the formal mechanism by which the Department and the Minister for Health are informed by the HSE in an anonymised way of serious patient safety incidents that occur in health services.
Through this protocol my department is kept updated regarding the completion of incident reviews, the implementation of the recommendations and learning from reviews to improve services locally and nationally.
Following on from this initial notification a number of matters in the paediatric orthopaedic services were brought to my Departments attention, resulting in several reviews focussing on the paediatric services in Children’s Health Ireland. The Deputy will be aware that a number of these reviews are still ongoing and on completion of all these reviews further consideration will be given to any additional actions required.
However, improvements and initiatives have been ongoing to these services since November 2022. This includes strengthening governance and oversight, driving down waiting times, ensuring increased engagement and timely communications with families of patients with a view to building a better and more responsive service.
The deputy will be aware that the Minister appointed Dr Yvonne Traynor as Chairperson of the CHI Board along with two additional Board members. This builds on the previous appointments of six new board members in 2025; three of whom are also HSE Board Members, and one who is a member of the National Paediatric Hospital Development Board. The Minister has also confirmed her intention to integrate CHI into the HSE.
The Government and the HSE have prioritised investment into these services including funding to deliver an increase in permanent capacity and staffing, resulting in record levels of activity and a reduction in waiting times.
A comprehensive patient safety review and assurance process, overseen by the HSE and its Chief Clinical Officer Dr Colm Henry, was undertaken at Children’s Health Ireland (CHI) Temple Street into elements of the paediatric orthopaedic surgery service.
Establishment of the Paediatric Spinal Services Management Unit, led by a Consultant Orthopaedic Surgeon and supported by wider Multi-Disciplinary Teams, to ensure patients are prioritised correctly for surgery and works towards reducing waiting times was established. Other initiatives underway to help improve access to services including a ringfenced theatre, additional outpatient clinics and national and international outsourcing to maximise capacity.
The HSE CEO has established the HSE CHI Improvement Steering Group to co-ordinate oversight of the range of matters of focus in CHI, including the implementation of recommendations from completed reviews, upcoming reports, spinal services, and the commissioning of the new hospital. This group, chaired by the REO Dublin Midlands, meets on a monthly basis.
The HSE CEO has also commissioned an audit to assess governance and equity in access to care within CHI, especially regarding the balance between public and private patient management. The audit is looking at processes for patient referral pathways, waiting list administration, NTPF participation, waiting list action plan participation, consultant clinic scheduling, and patient billing.
The audit is being augmented with a qualitative element, capturing patients and staff experiences. This qualitative element will inform overall observations and improvement plans.