Parents finding it harder to look away from scandals at CHI — if they ever could

The series of scandals is now threatening trust between parents and healthcare workers, as well as between staff and their employer, writes Niamh Griffin

The report also stresses the number of CHI staff doing their best for patients, including people creating safe learning spaces for trainee doctors. File Picture: Colin Keegan/Collins Dublin

What must be going through the minds of parents with a child in Children’s Health Ireland (CHI) this week? Or staff working in hospitals over which dark clouds are growing?

A series of scandals is now threatening trust between parents and healthcare workers, as well as between staff and their employer.

Over 250,000 children are treated every year between CHI at Tallaght, Temple St, and Crumlin, along with some care in the National Orthopaedic Hospital Cappagh. About 22% come from outside the greater Dublin area, referred from other hospitals for specialist care.

Among the initial concerns were waiting lists for scoliosis and spina bifida — a small but vulnerable group. It was perhaps possible for many parents to think "ah that’s terrible, but it’s not my child".

Then, in 2023, came concerns about how surgery is supervised. How did unapproved springs get through supposedly fail-sale procedures into three children’s spines?

This year, concerns about hip dysplasia surgeries arose. This is a condition which studies indicate could affect between 400 and 1,800 babies born in Ireland every year, according to Hiqa.

Over 2,200 families have received review letters. Appointments have already started, running Saturdays and week-days under a six-month deadline set by the HSE.

Then came revelations on how some children with a shared diagnosis — known within CHI informally as "orphans"  — had “sub-optimal care”. One staff member told the review: “How can you have patients that aren’t someone’s responsibility?”

This unpublished report, seen by the Irish Examiner, also questioned use of National Treatment Purchase Fund (NTPF) money for weekend clinics.

Then came an audit of Ireland’s only critical care units for children in Temple St and Crumlin hospitals. 

No concerns were raised about treatment, but it found these intensive care units are 'under strain' from severe overcrowding and staff shortages

It highlighted the high number of crisis transfers to these under-pressure units from other hospitals. 

Now, parents everywhere are finding it harder to look away — if they ever could.

'Inequalities' in treatment

The unpublished report found “inequalities” in treatment for one group of children, saying their care was left in limbo. It could not identify how many children are affected, with estimates from five to 80.

It also looked at how NTPF insourcing — funding of hospitals in a group to have patients on the waiting lists for the longest time seen at a sister hospital — worked in one service.

Some 179 children were seen at weekend clinics, but it found some waiting longer were skipped over.

It said 95% of those seen could have gone to another CHI service in normal working hours with shorter waiting times.

It also highlighted a smaller number waiting for an operation which should be done before a child is 18 months. These children are at risk of fertility issues or cancer if not seen in the appropriate time, it said.

NTPF funding for the clinic included €35,800 for the consultant

On Friday, the NTPF paused insourcing funding to CHI while reviewing spending.

Last year, the NTPF funded insourcing at €1,287,544 in CHI. So far this year, costs came to €374,989, a spokesman told the Irish Examiner.

The HSE has referred the report, which CEO Bernard Gloster only became aware of after it was published in the Sunday Times, to gardaí for possible investigation.

Health minister Jennifer Carroll MacNeill was also blindsided, asking parents for patience while this is investigated.

While CHI at first did not intend to publish this for legal reasons, it later pledged to publish a summary of recommendations and actions.

'Committed to transparency'

“CHI takes very seriously its responsibility to the families we serve and is committed to transparency. CHI also has an obligation to its staff and internal processes,” a spokeswoman said.

It is notable this review, completed in January 2022, refers back to a 2017 review of specific patients’ care, saying there is “a lack of clarity” around actions taken to fix problems since then.

The review also found nurses and doctors faced 'a toxic and siloed culture'

One nurse said: “I couldn’t stop crying, I wasn’t sleeping."

Another explained they were having panic attacks at work. Formal complaints were made about bullying.

Some staff, in roles not identified in the report, were afraid to take part because of potential negative impacts.

A graphic includes "broken culture" as well as "leadership and governance" in a list of challenges facing CHI as a whole.

The report also stresses the number of CHI staff doing their best for patients, including people creating safe learning spaces for trainee doctors.

CHI has carried out reviews into issues, such as the unapproved springs, due to internal whistleblowing.

These hospitals will transfer to the new €2bn children’s hospital in Dublin, possibly next June.

The question now for new CEO Lucy Nugent and her team along with the HSE and the health minister is: Can they get a handle on all of these issues before those doors open?