CHI only published summary of critical report 

The report highlighted that money from a fund for tackling waiting lists was used to run clinics where children selected were not among those waiting the longest. Stock picture: Niall Carson/PA

Children’s Health Ireland only published a summary of a critical report on waiting list funding in its hospitals and defended its choice not to discuss some findings with families.

The unpublished report — which was critical of how funding was used to reduce waiting lists and highlighted bullying and other serious issues — has been widely covered and discussed including in the Irish Examiner over the last three weeks. 

The report highlighted that money from a fund for tackling waiting lists was used to run clinics where children selected were not among those waiting the longest. 

It said many of those children could have been seen elsewhere and likely seen faster.

On Monday, the hospital group defended its decision not to raise these waiting list clinics with families. CHI said: 

Open disclosure was not carried out as there is no significant scientific evidence that delaying treatment will equate to patient harm in this patient cohort. 

It said a review of the inpatient list was carried out and the children were re-distributed across the department.

Suboptimal care for 'orphans' 

The unpublished report also highlighted gaps in care for a group of children known as ‘orphans’ at one hospital in CHI. It said they received suboptimal care compared to children with the same condition treated at another hospital also in CHI.

The review team could not clarify how many children were affected, saying numbers shared with it indicated between five and 80. This published summary does not directly address those concerns.

A CHI spokeswoman clarified on Monday afternoon that comments in relation to open disclosure refer to "all relevant patient cohorts". 

Weekend clinics

CHI said the weekend clinics —  funded by the NTPF (national treatment purchase fund) — were not held in any consultants’ private clinic, and scheduling was done by the hospital’s administrative staff.

“No direct payments were received by CHI staff from the NTPF,” it said.

Funding for this waiting list initiative was received by CHI directly from the NTPF. Staff are only paid for additional work by CHI, over and above their contractual hours.

It now runs a central referrals office for its hospitals.

In relation to funding issues, it said there are now “multiple internal stakeholder approvals” needed for clinical and financial decisions around NTPF waiting list programmes.

Concerns about the use of NTPF money have since spread to other areas, with the fund asking all hospitals to submit data on this by Monday.

CHI insisted on Monday that “the majority of the recommendations” made in the report have been acted upon.

It said the report was shared with the CHI board and executive in April 2022.

The unpublished report also highlighted examples of bullying and disrespect at all levels among staff. 

The summary acknowledged findings on one department said “change was slow, lacked governance and robust processes, and was influenced by strong and challenging personalities”. It acknowledged this “has the potential to put patients at risk”.

CHI said it put an action plan into place in response to these findings.

The summary document concluded: “This examination however, without question has demonstrated that there is a huge cohort of committed, diligent, people centric staff across CHI willing and wanting change and reform. It is this cohort of staff with the support of strong leader’s and good governance that will mend our culture and enable positive change across CHI.”