Internal report confirms public child patients forced to wait for surgery – private patients prioritised

An internal report obtained by The Ditch has exposed hospital consultants prioritising private child patients over those on public lists – with public patients forced to wait significantly longer for vital surgery. 

With one urology consultant, public patients have waited almost a year longer for surgery than those with private health insurance. Some children have waited an average of more than six months longer for time-sensitive spinal surgery because they were not privately covered.

“Like private care in maternity hospitals,” said People Before Profit TD Paul Murphy, “it should have no place in our health system,” about the report examining healthcare at Children’s Health Ireland (CHI) facilities.  

"So much for cherishing all the children of the nation equally. It’s disgusting that access to healthcare in this country, even for children, is determined not on the basis of need but on the ability to pay. This legalised discrimination against working class and poor children is happening so wealthy consultants and private healthcare companies can further enrich themselves.”

The report demonstrates that the current system is set up to ensure profit

EY compiled the report and delivered it this spring.

It examined the work of seven Children’s Health Ireland consultants who carried out spinal, urology, general orthopaedic and respiratory surgery and care between 2023 and 2025.

The consultants, categorised by number rather than name, were selected for review because more than 20 percent of their work was private and their public patients were waiting longer. 

A total of 131 children’s healthcare was reviewed for the part of the report seen by The Ditch.

They were being treated for general orthopaedic (20), spinal (22), urology (73) and respiratory (16) conditions.

One HSE employee familiar with the report said that the findings are indicative of the inequality in Irish healthcare.

“While officially there should be no difference in waiting times whether you are a public or private patient, the reality is much different. Otherwise why would anyone have private medical insurance?

“The report demonstrates that the current system is set up to ensure that profit is a very successful, if immoral, motivating factor for the speed of healthcare provision in the state.”

The report also found in 2023 alone the HSE paid more than €2.1 million for children’s spinal surgeries at Dublin’s private Blackrock Clinic despite senior health staff insisting there was capacity in public hospitals.

At a meeting of the Dáil public accounts committee at the end of April, People Before Profit TD Paul Murphy asked CHI chief executive Lucy Nugent whether CHI consultants were being paid €10,000 for every procedure they carried out at Blackrock.

Nugent said she didn’t know.

“Idiopathic scoliosis patients are being siphoned to Blackrock clinic, where everyone, including the institution, makes substantial earnings while institutions like the the National Orthopaedic Hospital at Cappagh remain underutilised,” the HSE staff member added. 

The year Blackrock Clinic received the €2,109,000 cited in the report, there were 39 publicly funded idiopathic scoliosis procedures conducted in the clinic.

This rose to 48 in 2024. 

By the end of November last year there were 67 such surgeries carried out at the clinic. 

The HSE paid Blackrock directly for these procedures, with the clinic then paying the CHI surgeon a fee which would be in addition to their public salary.

At the same public accounts meeting in April, CHI clinical director Paula Kelly insisted Cappagh has the capacity for these surgeries. 

The EY report found there was no formal process for how funding for outsourcing to institutions such as Blackrock Clinic should be “reviewed, approved and evidenced”. 

While National Treatment Purchase Fund or HSE approval was later confirmed for “all initiatives”, formal funding requests and approval were often “missing or incomplete”.

There were “data issues… missing or incomplete booking forms, unclear dates, or missing planned procedure dates”. 

In some cases there wasn’t evidence of funding requests while in others “verbal agreements” took the place of appropriate documentation.

After a series of scandals involving spinal surgery and waiting lists the HSE announced last year it’s disbanding CHI.

The HSE declined to provide figures for how much public money Blackrock Clinic received for spinal surgeries in 2024 and 2025. 

CHI was contacted for comment.