Surgeon holds Cork child clinic for free

A DUBLIN-based surgeon who travels to Cork to host a monthly clinic for children with severe physical disability has never been paid for the service. The clinic not been acknowledged by the HSE.

Pat Kiely, a paediatric orthopaedic surgeon who works in Tallaght and Crumlin children’s hospitals, travels to Cork in his own time to hold a clinic at Enable Ireland’s Lavanagh Centre in Ballintemple.

Mr Kiely said the clinic was set up in 2009 after it became apparent that children with complex physical disability were in danger of missing out on the timely service they needed to prevent their condition from deteriorating.

“Part of the orthopaedic population are children with neuromuscular problems with disability. It was becoming quite apparent that there were a number of them attending already very busy clinics. That isn’t the ideal way of dealing with, or managing, patients with complex problems that really should be dealt with in a multidisciplinary setting in a specialist kind of clinic.

“So we took the initiative two years ago to start this process and we started a clinic on a monthly basis.”

However, he said there had never been “any official correspondence to actually acknowledge it exists from the HSE in the South”.

“I suppose the reason for that is that they are afraid that there may be a demand on resources if they do acknowledge that the clinic exists,” Mr Kiely said.

Mr Kiely is also part of a rotating team of paediatric orthopaedic surgeons who travel from Dublin once a month to hold a clinic at St Mary’s Orthopaedic Hospital in Cork. This arrangement, which Mr Kiely said was meant to be “a temporary stop-gap” is now in place for four years since the retirement in 2007 of Anthony McGuinness, which left the south of the country without any paediatric orthopaedic surgeon.

Recently, the HSE has appointed two orthopaedic surgeons with a special interest in paediatric orthopaedics, but the first will not take up the post until January next year.

The second appointee is expected to commence work next summer. The HSE said that once the two surgeons commence, “the requirement for visiting Crumlin-based orthopaedic consultants to provide such out patient clinics will be negated”.

Currently, the HSE reimburses the four consultants who provide the out-patient clinics at St Mary’s Orthopaedic through payment on a sessional placements.

However, in relation to Mr Kiely’s additional work at the Lavanagh Centre, the HSE said it has a service level agreement in place with Enable Ireland “to provide a range of services to children with physical and sensory disabilities” and that, under this agreement, “there is no provision for an orthopaedic clinic to be held in the Lavanagh Centre”.

The HSE said all clinics associated with this agreement are held at St Mary’s Orthopaedic Hospital.

A spokesperson for Enable Ireland said the clinic with Mr Kiely was set up in 2009 to facilitate a better service for children attending its service who also attend Mr Kiely’s practice in Cork or Dublin.

“Having the clinic on site allows Enable Ireland staff to attend and means that families don’t have to attend two clinics. Mr Kiely receives no fee from Enable Ireland for the service,” the spokesperson said.