Screening to help babies avoid hip dysplasia surgery still not in place, eight years on
Up to 100 children a year undergo invasive hip surgery because of a late diagnosis. Many of these could be avoided if the screening programme mooted in 2017 were in place. Picture: Thinkstock
A national screening programme to help babies with hip dysplasia avoid surgery is still not in place eight years after it was recommended.
The steering group that made the recommendations was disbanded by the HSE this year. However, none of its recommendations have been implemented.
Up to 100 children a year undergo invasive hip surgery because of a late diagnosis, it is estimated.
In 2017, the steering group recommended the introduction of a national screening programme to avoid any unnecessary surgeries.
Last year, the watchdog, Hiqa, raised concerns that the recommendation had still not been acted on.
The watchdog said: “Current practice is, therefore, not supported by the governance, end-to-end care, quality assurance, and monitoring of outcomes that would be associated with such a programme.”
They found evidence that even in the limited approach taken to screening, “there may be variation in the implementation” between hospitals.
One consultant said that if problems with hip dysplasia are detected early enough there might not be any need for surgery. The consultant said:
“Problems arise when the diagnosis is made late. The sooner you spot it, you can treat it in a harness or a brace. And the children respond very well and have excellent results.”
However, without a national register, the consultant said:
The consultant, who is familiar with care for hip dysplasia, said: “The whole point about DDH [hip dysplasia] is if you treat it in time, it can nearly all be done non-operatively.”
In recent weeks, there has been public outrage over the high number of surgeries and unnecessary surgeries in CHI at Temple St and the National Orthopaedic Hospital, Cappagh.
The consultant said: “In the recent CHI report, if you subtract the unnecessary operations from the overall number, you are left with a lot of necessary operations. In many cases, it is likely that they were necessary because of late diagnosis.”
There is now concern in health circles at what the CHI crisis could mean for efforts to address the gaps.
“The whole thing is in chaos now. It’s probably seen as toxic. There is no sense of urgency, no sense of determination to get this done,” the consultant warned.
Sinn Féin health spokesman David Cullinane said that not only were recommendations not implemented, but also “no national database or audit was ever put in place”.
“It is worrying that these recommendations were not implemented and this has caused understandable concern for those involved in this valuable work.”
The HSE said health regions are now responsible for screening.
The Department of Health pointed to communication from the NSAC last month to doctor’s groups who raised concerns saying the best approach “would likely be the systematic application of the current selective screening programme”.
