Hospitals will be issued with guidelines later this year for carrying out circumcisions on cultural or religious grounds, the Department of Health said last night.
This followed a recommendation by a South Eastern Health Board (SEHB) public health specialist that such circumcisions be carried out on a monthly basis at Waterford Regional Hospital.
The recommendation was made in the absence of any national guidelines on the issue.
It followed the death of the four-week-old baby, Callis Osaghae, at Waterford Regional Hospital last August, after a home circumcision went wrong. A man is currently on bail in connection with the baby's death.
Most Muslims require their children to be circumcised by six months of age but many hospitals do not carry out circumcisions on religious or cultural grounds.
Yesterday, a Department of Health spokesman said an advisory group would make national recommendations on the issue within the next three to six months. Prof Denis Gill of the Royal College of Surgeons was recently appointed to chair the advisory group but it is understood that the members have not yet met.
Dr Neville DeSouza, a SEHB public-health specialist, made his recommendations to the SEHB's general hospitals' committee last month. The report is expected to be presented to the board at its February meeting.
The board is likely to accept the recommendation but it will then have to make recommendations on funding to implement the service.
The service would cost about €20,000 a year, according to one estimate. Medical and clinical policies and a service plan will also have to be drawn up to cater for the new service.
Dr DeSouza recommended that a surgeon in Waterford Regional Hospital carry out the procedure one day a month, and that facilities be provided for post-operative care.
He found that a maximum of 100 children a year could require circumcision in the SEHB region but said the figure would probably be much lower than this.
Dr DeSouza found that while hospitals did not routinely carry out male circumcisions on cultural or religious grounds, most health boards indicated to him that they had made arrangements on an individual basis for providing this circumcision.
He said it was a matter for society as a whole to develop policies on circumcision. "Nonetheless, the health board has responsibility for protecting children in the region and has to make arrangements for providing a service to those who require circumcision for medical, religious or cultural reasons."
Most children of African origin were circumcised for cultural reasons, his report said. "If these infants are not offered a service by the health board, the parents will turn to individuals who lack the skills and experience to perform it safely and competently, and the lack of provision of adequate post-operative care."
Even in the best circumstances, post-operative complications could arise, he said. When circumcisions were carried out in "a less-than-satisfactory environment", the complications could include uncontrolled bleeding, acute renal failure and even death.
Because most children involved were those of refugees or asylum-seekers, they were not in a position to seek medical intervention, Dr DeSouza said.
While routine circumcision is not available on the NHS in Britain, the General Medical Council and the British Association of Paediatric Surgeons have issued guidelines for surgeons and doctors on ritual circumcision.
