It is clear from correspondence and public comments that there has been growing frustration on the part of Minister for Health Stephen Donnelly with Children’s Health Ireland (CHI), the group that runs the main children’s hospitals in Dublin.
In fact, in a letter in August to the chairman of the group over waiting times for children needing orthopaedic surgery, Donnelly used that exact word.
“I cannot overstate the level of frustration within Government,” the Minister told the chairman, Jim Browne.
There have also been other issues. Earlier this year Donnelly criticised the CHI board for delays in seeking a new permanent chief executive. Late in 2023, the Minister refused consent for a board proposal to reappoint its previous chief executive to a third term as this went against government top-level employment policy.
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The Minister also raised concerns about a €19 million investment by the Government to improve spinal and orthopaedic services.
In July, the Minister told the Seanad that these funds were not used in the manner in which he had intended and waiting lists remained “unacceptably long”.
It is understood this audit report has been considered by the Health Service Executive management and board and will be published in the coming days.
It is expected it will not find any misappropriation but that the money had not always been prioritised for the group of children intended.
The report is also likely to highlight delays in putting in place additional capacity – both capital and staffing.
The Minister may have had a veto on the reappointment of the former chief executive. However, neither Donnelly nor the HSE have any direct role in running hospital services for children in the capital.
Although hospitals in CHI are funded by the exchequer and staff are considered to be public servants, the group is a voluntary organisation with its own management and board.
Voluntary hospitals jealously guard their independence and fought a strong rearguard action when in 2017 Simon Harris, then Minister for Health, established a group to look at the future role they should play in the Irish healthcare system.
The group, ultimately, recommended that the State should not take over the voluntary hospitals and agencies.
In addition to frustrations over waiting lists and other issues, it is likely Donnelly could see the huge matter of the commissioning of the new €2 billion national children’s hospital coming down the track.
CHI will be responsible for merging the three existing paediatric hospitals and for running the new facility.
It is against the backdrop of these issues that it is likely Donnelly wanted to know, legally, his options if the State had to step in and intervene directly.
Any such move would be hugely controversial and, his legal advice maintained, could only be undertaken if an independent review pointed to serious failings.
The Department of Health, the Government and the voluntary hospitals will watch now with even greater interest the outcome of the Hiqa investigation established last year into another CHI controversy – the governance and oversight of processes within the organisation on the use of surgical implants/implantable medical devices during some surgeries at Temple Street.
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