CHI hospitals can continue to train doctors, Medical Council determines

The grounds of CHI Crumlin. The council assessed CHI at Temple St against standards for intern training. It assessed Temple St, Crumlin, and Tallaght against criteria for training sites. File picture

All Children’s Health Ireland (CHI) hospitals can continue to train doctors, but improvements in HR, including rostering of doctors and IT, are needed for patient safety, according to the Medical Council.

The council inspected CHI in September following claims in an internal report about bullying and a “toxic” work culture.

A senior CHI consultant, paediatrician Sinéad Murphy, said in response to the council report that concerns raised about bullying in “one or two departments” have now “absolutely been addressed”. 

Dr Murphy linked the IT and HR issues partly to the delayed move to a new hospital, saying she is “hopeful” staff will be in by this time next year.

The council assessed CHI at Temple St against standards for intern training. It assessed Temple St, Crumlin, and Tallaght against criteria for training sites.

“The assessor team were satisfied with the training provided to interns at CHI at Temple Street,” the council said. Overall, it found that "culture across CHI was described as supportive and collegial by most". 

However, it advised that the council’s guide to professional conduct and ethics be promoted to “safeguard public confidence in CHI doctors”.

The council found “patient safety concerns were raised primarily as a result of operational inefficiencies such as HR and ICT”.

HR problems included “significantly delayed salary payment”, lack of ID badges and incorrect rota staffing lists, as well as cover for leave.

It said doctors were committed to “high-quality patient care, often in the face of challenges related to inadequate HR and information communication technology resources”. 

It found that “consultants frequently attended the hospitals out-of-hours”, and a better system for reporting concerns was recommended.

The internal, as yet unpublished report, found some staff reluctant to raise concerns and not heard when they did. Council chief executive Maria O’Kane said: 

The visit followed significant concerns from multiple sources regarding findings from an internal examination by CHI in 2021and 2022.

Dr O’Kane said the inspections were to ensure “patient safety is not compromised”.

Sinéad Murphy, regional director of post-grad training at CHI and consultant paediatrician, told the Irish Examiner: "The issues were not institution-wide. The issues were very much related to one or two departments. 

“We knew that that happened. We knew that otherwise the training environment was always positive.” 

Those issues have “absolutely been addressed”, Dr Murphy insisted.

She described how new trainees this month were encouraged to share concerns and told how to do so.

The ongoing merger of three HR teams led to some issues falling between the cracks, she acknowledged.

“The IT situation is old in some places, less old in others,” she said. "That’s posing a big challenge. And we feel that lots of those challenges will be addressed once we get over this move.” 

So far, only one floor of the €2.2bn hospital has been handed over to CHI. 

“We would be hopeful that by this time next year we will be embedded,” Dr Murphy said. The handover had been expected for 2022. 

• Niamh Griffin is Health Correspondent.