Children’s Health Ireland (CHI) is no stranger to hitting the headlines. In 2023, then chief executive of the children’s healthcare provider Eilísh Hardiman told politicians about issues in Temple Street children’s hospital’s orthopaedic unit.
“Decisions were made, certain procedures were carried out, children were subjected to a higher-than-expected number of unplanned return trips to theatre and, alarmingly, unapproved, non-medical-grade devices were implanted in three children,” she said at a meeting of the Oireachtas health committee.
She described this as “a shocking litany of events”.
She was not the only person who felt that way. There was widespread concern within the government as well as patients and their families, particularly around the use of unapproved, non-CE-certified springs in three patients requiring spinal surgery.
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The springs were described by Health Service Executive (HSE) officials as unauthorised, uncertified implantable devices. Two of the springs were removed.
The orthopaedic surgeon at the centre of the controversy ceased carrying out spinal surgery in November 2023 and has been referred to the Medical Council by CHI.
As a result, a number of reviews were issued into their use, including an independent review led by Selvadurai Nayagam, a consultant in orthopaedics and trauma at Royal Liverpool children’s hospital.
The HSE said this is progressing but it is not yet aware of a completion date.
On Tuesday, the Health Information and Quality Authority (Hiqa) will publish its report on the governance of the use of non-surgical implants in CHI.
Speaking in November 2023 following the publication of the terms of reference of the inquiry, Sean Egan, Hiqa’s director of healthcare regulation, said the review aims to “determine the end-to-end processes around any use of non-CE spring implants during spinal surgery in CHI at Temple Street”.
“It will also assess the controls, oversight processes and governance arrangements in place within all CHI hospitals and services for the use of such implants and medical devices, including internal governance processes in meeting regulatory requirements,” he said at the time.
In short, it should paint a picture of who knew what and for how long.
The controversy is another blow to CHI, which had already faced significant public criticism for long waiting lists for children with scoliosis and spina bifida who require spinal surgery.
Families turned to the media, going public with their stories of how their children experienced debilitating pain as they sat on waiting lists for months.
Steps were taken to try to improve this situation, and a record 513 paediatric spinal surgeries were carried out in CHI last year. This is a 10 per cent increase on the 464 procedures in 2023 and a 35 per cent rise compared with 2019.
A total of 87 spinal surgeries were carried out during the first two months of this year, while 110 new patients were added to the waiting list in the same period.
The number of children waiting more than four months fell from 86 in January 2024 to 54 by the end of the year.
Additional funds were ring-fenced to tackle scoliosis waiting lists, while provisions were made to have children treated in New York and London, and additional staff have been hired or are in the process of being hired.
But despite all of this, a significant breakdown in trust occurred between many of the families and CHI.
Following the publication of Hiqa’s report, rebuilding this trust will be one of the big challenges going forward.
