‘Deep concern’ at no clinical oversight at Cappagh & Temple Street

Labour Health Spokesperson, Marie Sherlock TD, has expressed her deep concern at the findings of the Independent External Medical Audit for Children’s Health Ireland and National Orthopaedic Hospital Cappagh on Indications for Pelvic Osteotomy in Children with Developmental Hip Dysplasia.

Sherlock has called on the Minister for Health to make a full statement on the matter in the Dáil on Tuesday.

The Dublin Central TD said “the external review into hip surgeries in children with Developmental Hip Dysplasia paints a distressing picture of the systems in place and clinical governance at Children’s Health Ireland. ”

“The Minister must make herself available in the Dáil on Tuesday to detail what exactly happened, who knew what and when, and the impact that this will have on current services.”

“While the need for most surgeries at Crumlin Children’s Hospital were reasonably indicated, it is deeply distressing that significant numbers of pelvic osteotomies for children in Temple Street and NOHC did not reach the clinical criteria for surgery, with only 40% meeting clinical criteria in Temple Street and 21% in Cappagh.”

Sherlock noted”the audit further notes that most children at Temple Street and NOHC had undergone pelvic osteotomy using a novel technique and that children were often discharged by some surgeons around one year after pelvic osteotomy.”

“While the report suggests that this technique was driven by use of a novel technique, this technique had little to no oversight, not enough follow up on development of children post-surgery, and no peer review across all hospitals to agree to common clinical practice, as recommended by the audit.

“The audit raises stark governance concerns regarding informed consent for parents in understanding this novel technique, the risks involved in performing this surgery in their children, and the lack of longer term follow up.

The Labour TD said “these innovations did not take place within appropriate structures.”

“CHI and individual hospital structures should have been notified of these surgical innovations, particularly the Board of CHI and the Quality and Patient Safety Committee within the Board.

“I welcome the changes now made which will ensure a single peer reviewed decision making process.

“However, with very significant waiting lists for orthopaedic procedures, we must ensure that additonal resources are put in place so that no slow down in activity arises.

“Today, there are hundreds of parents who are experiencing huge levels of anxiety with the publishing of this audit. I am thinking of them and their children as they now navigate this exceptionally difficult and upsetting situation.

“I welcome that the HSE has responded with an independent clinical review, as recommended by the audit, which will be offered to all patients on an opt-in basis. While I am conscious that the HSE is working to put an external review team in place, the timeline is not clear.

“I am calling on the HSE to provide a timeline as to when this external review team will be in place to help address anxiety of parents. It is imperative that all 497 pelvic osteotomy cases that took place in all three hospitals between 2021-2023 are reviewed urgently., as well as cases before 200 if necessary for those wishing to be assessed.”