CHI failure to deliver international best practice 'harmed' children, among findings of report

Some of the children may develop cancer or be infertile due to delays related to a procedure which should be done by 18 months old. File picture: Colin Keegan/Collins

The unpublished report, seen by the Irish Examiner, into concerns at Children’s Health Ireland hospital identified: 

• An unknown number of children — between five and 80 — with the same health condition receive “suboptimal” care at this hospital compared to how patients with the same condition are treated in another CHI hospital.

They were known as ‘orphans” internally, with one staff member interviewed saying: “How can you have patients that aren’t someone’s responsibility?”

• Some of the children may develop cancer or be infertile due to delays related to a procedure which should be done by 18 months old.

• The review quotes another unpublished report from 2017, which warned of similar problems for these patients. It says by 2021 they found “lack of clarity” about actions taken on that older report.

• National Treatment Purchase Fund monies given for ‘insourcing’ to run extra clinics for 179 children is questioned. Some 95% of children seen could have been seen in another service during regular hours without extra funding. Some could have been seen sooner. Some of the children were referred to an inpatient waiting list which was longer than at another service which could have treated them. The review found this was “potentially negligent”.

• Risk assessment in 2021 for one national service said children being treated “have a poor experience or are harmed due to the inability of CHI to deliver international best practice standards of [this care]”. It was given a risk score of 20 out of 25 

• A “toxic culture” was identified, with three specialist nurses leaving one service between 2013 and 2021. Comments show one person had panic attacks at work. Trainee doctors faced a “psychologically unsafe environment” in one department reviewed.

• Some 89% of people interviewed described “a culture where change was slow, which lacked governance and robust processes” across CHI as a whole, while 43% said “they wanted to see real change across CHI”.

• A defamation case is on-going between two consultants, which the report linked to “fraught relationships” between two services in which they work.