Children’s Health Ireland (CHI) didn’t inform parents affected by the ongoing hip surgery scandal – because of internal opposition – till after The Ditch’s publication of a draft report that concluded children were being operated on unnecessarily.
Despite having this report since early January, it wasn’t till mid-to-late March – after The Ditch published the draft report – that CHI management sent letters to families. According to a whistleblower at CHI, some staff members opposed the move and CHI had received legal advice about the implications of telling affected families.
“There were several conversations about it and it went through a number of drafts due to internal opposition – to one extent or another all attempts at communication with families over the last couple of years of scandals have faced internal opposition,” said the whistleblower, adding “CHI has been entirely reactive to the press articles rather than doing the right thing for parents and children.”
Last week in the Dáil education minister Helen McEntee criticised The Ditch’s publication of the report, saying affected parents didn’t want the draft report made public. “They certainly don’t want parts of an unpublished document being published elsewhere, not coming through the minister, not having that direct engagement, be with the minister, with CHI or with the other hospitals involved here,” she said.
Though the letters CHI finally sent refer to operations as far back as 2010, the experimental dysplasia surgery concerned was being performed on children at a Dublin hospital as far back as 2002.
A medical journal article reviewed by The Ditch discusses the surgery being conducted at Temple Street between 2002 and 2006. “Strictly speaking, they are now beyond the remit of CHI, but why are these patients not being included in any follow-up plans? I think they’re trying to limit the magnitude of the problem,” said the whistleblower.
‘But they have failed spectacularly’
An external audit by an NHS consultant found that 80 percent of osteotomies on children in Cappagh hospital and 60 percent of those in Temple Street were unnecessary, as reported by The Ditch in February.
This followed a previous Ditch report almost a year ago where a whistleblower voiced concern about surgeries being carried out “purely for financial gain”.
Despite having a draft report in early January, Children’s Health Ireland management didn’t inform families of the impending scandal till March.
The earliest letter reviewed by The Ditch is dated 19 March – six days after the publication of the full report – while others are dated 24 March.
The Ditch has seen correspondence indicating the letter was drafted, but unsent, for a long period beforehand.
“The draft report was known to CHI from early January and a letter was drafted to parents but not sent. One reason for the delay was management seeking legal advice, an attempt to get all their ducks in a row. But they have failed spectacularly,” said the CHI whistleblower.
Though the expert report covers 2021-2023 and CHI has confirmed it’s contacted parents of former patients dating back 15 years, a medical journal article confirms the related operations have been conducted in Dublin for at least 23 years.
The Journal of Pediatric Orthopaedics published the article, titled Less invasive innominate osteotomy, in July 2010.
While 2,260 letters have been sent to the parents of children operated on in Cappagh, Crumlin and Temple Street hospitals over a 15-year period, the whistleblower is concerned the number of affected children could be as high as 3,500.
“The fact that these procedures were being performed since the early 2000s is widely known throughout CHI,” said the whistleblower.
“As such, there are now adult patients who may have complications or adverse repercussions from surgery. The bottom line is we’re talking about an experimental procedure with no long-term follow up.
“What should have been done at the time was a long-term follow-up study showing complications and repeat operations. There are a cohort who have had a second osteotomy, making you wonder if the first one worked at all.
“While the author of the draft report only recommended reviewing paediatric patients, he didn’t mention those who had aged out of CHI’s remit, I think it would be fair to review all the patients who have had the procedure. This should not represent a formidable task,” they said.
CHI has been contacted for comment.
