I must now deal with a postponed division relating to the motion regarding unnecessary hip surgeries at Children's Health Ireland. On Tuesday, 29 April, on the question, "That the amendment to the motion be agreed to", a division was claimed and in accordance with Standing Order 85(2), that division must be taken now.
Unnecessary Hip Surgeries at Children's Health Ireland: Motion (Resumed) [Private Members]
The following motion was moved by Deputy David Cullinane on Tuesday, 29 April:
That Dáil Éireann:
notes with alarm the results of a clinical audit conducted on children's hip surgeries performed on children under the care of Children's Health Ireland (CHI), which:
— audited 147 cases across 14 surgeons across 3 institutions for the period 2021 to 2023, namely CHI at Temple Street, CHI at Crumlin, and National Orthopaedic Hospital Cappagh; and
— found that, of those audited, 60 per cent of the surgeries at Temple Street were not indicated, 79 per cent at Cappagh were not indicated, and 2 per cent at Crumlin were not indicated;
further notes that:
— not all of these surgeries were conducted through the public system, but that many were conducted privately with even less oversight of care;
— many parents sought second opinions and that there are cases where the second opinion considered that not only did the child not require surgery, but that the diagnosis was incorrect;
— this malpractice has occurred under the watch of several Ministers for Health, who have failed to properly oversee the effective delivery of children's healthcare in this State and have instead operated at arm's length; and
— a final report into this matter has yet to be completed nor published;
furthermore:
— considers that a surgery conducted in circumstances where it is not clinically indicated according to best practice standards is an unnecessary surgery; and
— acknowledges that any surgery can be a traumatic experience for a child and their parents;
recognises that:
— potentially tens of thousands of hip surgeries have been conducted at these institutions over the last decade, and that parents of children who had these surgeries are left in the dark and wondering whether their child suffered an unnecessary surgery; and
— condemns the fact that there was no disclosure of these concerns and incidents despite the Minister for Health being made aware as far back as May 2024 and until the publication of the clinical audit by the Ditch media outlet, and that these concerns were kept hidden from parents and Dáil Éireann;
further recognises:
— that these revelations come at the same time as the completion of the Health Information and Quality Authority (HIQA) investigation into the use of non-medical grade implants in several children, which found severe governance and institutional failures at CHI; and
calls on the Government to:
— conduct an extensive review of orthopaedic surgical practice at CHI to uncover the extent of unnecessary surgeries on children, and to determine why these surgeries were conducted and whether a profit motive was involved in any of these cases;
— provide certainty to all parents of children who have had orthopaedic surgical practice at CHI;
— hold those responsible for these failures to account, at an individual, organisational, and political level; and
— ensure that as we transition into the new Children's Hospital that it provides the best quality care with the highest standards of governance, management, ethics, open disclosure and communication between families and medics.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
"recognises that:
— Children's Health Ireland (CHI) was made aware through the protected disclosure process of a concern relating to the threshold criteria being used for surgical intervention in relation to development dysplasia of the hip (DDH) September 2023;
— the concern related to different indications for DDH surgery between CHI Temple Street, the National Orthopaedic Hospital Cappagh (NOHC) and CHI Crumlin, with a lower threshold for surgery at Temple Street and NOHC for children, this resulted in different practices across the sites in CHI and NOHC;
— the Department of Health was notified by the Health Services Executive on 9th May, 2024 that a clinical audit was to be conducted in CHI and the NOHC;
— the clinical audit is being conducted by an external international expert on surgery for children with developmental dysplasia of the hip performed during the 2021-2023 period across CHI and the NOHC;
— the Minister for Health is awaiting the final report of the audit, which is expected in the coming weeks, before any conclusions can be drawn on this matter, further details will be shared once the process concludes, respecting confidentiality and due process;
— patients and their families will have understandable concerns, and CHI and NOHC have issued letters to families to provide reassurance and information about the audit pending its completion;
— as a patient safety precaution, a single cross-site pre-operative decision-making process for any planned DDH surgery in CHI and NOHC has been implemented, all cases are being reviewed before any decision for surgery is made by clinicians from CHI Crumlin, Temple Street and NOHC;
— an action plan is currently being drafted, this plan includes identification of groups of patients not included in the audit sample but who may be affected by any findings of the audit.
— plans are also being put in place for patient follow-up as required in line with good practice and will consider any recommendations with regard to clinical follow up from the final report; and
— a communications plan is also being developed to support the publication of the final report and further communications to patients and families.".
- (Minister for Health)
Amendment put:
The Dáil divided: Tá, 85; Níl, 68; Staon, 0.
Tá
- Aird, William.
- Ardagh, Catherine.
- Boland, Grace.
- Brabazon, Tom.
- Brennan, Brian.
- Brennan, Shay.
- Brophy, Colm.
- Browne, James.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Buttimer, Jerry.
- Byrne, Malcolm.
- Byrne, Thomas.
- Cahill, Michael.
- Callaghan, Catherine.
- Calleary, Dara.
- Canney, Seán.
- Carrigy, Micheál.
- Carroll MacNeill, Jennifer.
- Chambers, Jack.
- Cleere, Peter 'Chap'.
- Clendennen, John.
- Collins, Niall.
- Connolly, John.
- Cooney, Joe.
- Crowe, Cathal.
- Cummins, John.
- Currie, Emer.
- Daly, Martin.
- Dempsey, Aisling.
- Devlin, Cormac.
- Dillon, Alan.
- Dolan, Albert.
- Feighan, Frankie.
- Fleming, Seán.
- Foley, Norma.
- Gallagher, Pat the Cope.
- Geoghegan, James.
- Grealish, Noel.
- Harkin, Marian.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Heneghan, Barry.
- Heydon, Martin.
- Higgins, Emer.
- Keogh, Keira.
- Lahart, John.
- Lawless, James.
- Martin, Micheál.
- Maxwell, David.
- McAuliffe, Paul.
- McCarthy, Noel.
- McConalogue, Charlie.
- McCormack, Tony.
- McEntee, Helen.
- McGrath, Séamus.
- McGreehan, Erin.
- Moran, Kevin Boxer.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Moynihan, Shane.
- Murnane O'Connor, Jennifer.
- Murphy, Michael.
- Naughton, Hildegarde.
- Neville, Joe.
- O'Callaghan, Jim.
- O'Connell, Maeve.
- O'Connor, James.
- O'Donnell, Kieran.
- O'Meara, Ryan.
- O'Shea, John Paul.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cearúil, Naoise.
- Ó Fearghaíl, Seán.
- Ó Muirí, Naoise.
- Richmond, Neale.
- Roche, Peter.
- Scanlon, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Timmins, Edward.
- Toole, Gillian.
- Troy, Robert.
Níl
- Bacik, Ivana.
- Bennett, Cathy.
- Brady, John.
- Buckley, Pat.
- Byrne, Joanna.
- Carthy, Matt.
- Clarke, Sorca.
- Collins, Michael.
- Connolly, Catherine.
- Conway-Walsh, Rose.
- Coppinger, Ruth.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Cummins, Jen.
- Daly, Pa.
- Devine, Máire.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrelly, Aidan.
- Farrell, Mairéad.
- Gannon, Gary.
- Gibney, Sinéad.
- Gogarty, Paul Nicholas.
- Gould, Thomas.
- Graves, Ann.
- Guirke, Johnny.
- Hayes, Eoin.
- Healy, Seamus.
- Kenny, Eoghan.
- Kenny, Martin.
- Kerrane, Claire.
- Lawless, Paul.
- Lawlor, George.
- Mac Lochlainn, Pádraig.
- McGettigan, Donna.
- McGrath, Mattie.
- McGuinness, Conor D.
- Murphy, Paul.
- Mythen, Johnny.
- Nash, Ged.
- Newsome Drennan, Natasha.
- Ní Raghallaigh, Shónagh.
- O'Callaghan, Cian.
- O'Donoghue, Richard.
- O'Flynn, Ken.
- O'Gorman, Roderic.
- O'Hara, Louis.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Snodaigh, Aengus.
- Ó Súilleabháin, Fionntán.
- Quaide, Liam.
- Quinlivan, Maurice.
- Rice, Pádraig.
- Sheehan, Conor.
- Sherlock, Marie.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Wall, Mark.
- Ward, Charles.
- Ward, Mark.
- Whitmore, Jennifer.
Staon
Tellers: Tá, Deputies Mary Butler and Emer Currie; Níl, Deputies Pádraig Mac Lochlainn and David Cullinane.
Amendment declared carried.
Motion, as amended, put and declared carried.