It has been a fraught few months for Children’s Health Ireland (CHI), the operator of paediatric healthcare in the State.
There was the report from Health Information and Quality Authority (Hiqa) relating to the implantation of unauthorised springs into three children with scoliosis. Then came the audit report into the necessity of surgery for children with developmental dysplasia of the hip.
In May, another blow was dealt to the organisation when an internal report into one of its Dublin hospitals relating to a “toxic” culture, as well as potential irregularities in the way in which its waiting lists were managed, was widely leaked in the media.
The unpublished report revealed a consultant was seeing twice as many patients in Saturday clinics funded by the taxpayer through the National Treatment Purchase Fund (NTPF), and for which he received additional money than during his weekday equivalent, and for which he received additional money.
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Consequently, some children on waiting lists waited longer than they would have if they had been seen by another consultant, the review said, and were left at risk of infertility and cancer later in life.
The Health Service Executive (HSE) in June announced it had referred the report to gardaí, who said they were investigating allegations of fraud.
On Friday, The Irish Times reported that gardaí had identified no offences in its initial inquiries and would not be taking any further action.
This decision will be welcomed by the embattled provider of paediatric healthcare, which has said since the outset of the controversy the allegations did not meet the threshold for criminal activity, which was why it did not refer it to gardaí in the first place.
That does not mean everything the group is up against is now resolved.
[ National children’s hospital: what’s the hold-up - and whose fault are delays?Opens in new window ]
Séamus McCarthy, the State’s Comptroller and Auditor General, said at a meeting of the Oireachtas Public Accounts committee in July his office would be examining the report.
Due to the report findings around “financial risks”, this should have been brought to his office’s attention in 2022, he said, adding “the control implications” will be considered as part of its audit into the hospital’s 2024 financial statements.
In the midst of all of these concerns about governance, are, of course, sick children and their families.
Last month, families of children with scoliosis and spina bifida took to the streets of Dublin calling for improved access to spinal care, following the death of nine-year-old Harvey Morrison Sherratt, who died after waiting several years for spinal surgery.
Minister for Health Jennifer Carroll MacNeill said she has since received a timeline of his care, and both she and HSE chief Bernard Gloster have said they are happy and willing to meet with the family.
There is still one big piece of evaluation work into orthopaedic care that has yet to be completed. An external review into spinal care at Temple Street hospital, which began in September 2023, is still only at phase one with no date for completion given to the HSE.
A lot hinges on this review, which is being led by Dr Selvadurai Nayagam, including - sources say - the way in which CHI will operate in the future.
Ms Carroll MacNeill said she would like to wait until the Nayagam report is completed before she makes a decision about next steps.
Senior sources have said Government has an “open mind” about what will happen following this, which could include the establishment of some form of inquiry - something for which advocacy groups have long called.
In the meantime, it remains to be seen whether the already implemented changes - including recent appointments to the board - will be sufficient in easing the concerns in political circles about the way in which these services have been operated until now.
