ADVOCACY GROUPS FOR scoliosis patients have learned that a review into spinal surgeries at Crumlin hospital has been undertaken but not yet published by Children’s Health Ireland (CHI), the hospital group that also includes Temple Street.

The Journal understands that the unpublished internal review examined cases in which children who underwent spinal surgery at Crumlin suffered post-operative complications.

The groups, along with a solicitor for a number of families affected by serious problems in the spinal surgery service at Temple Street, have called for the Crumlin report to be published urgently.

The Scoliosis Advocacy Network said the audit was commissioned following the commencement of an internal review at Temple Street last November in response to concerns about poor surgical outcomes for spina bifida patients there, including the high incidence of complications and infections, and two serious incidents.

The advocacy group critisised hospital group management for not releasing further information about the nature of the report.

The report had been sought following concerns for a group of CHI Crumlin paediatric patients who it is understood suffered post-operative complications. 

Last week it emerged that one child died and others suffered serious complications following spinal surgery at Temple Street. Having initially refused to publish internal and external reviews that had been conducted on the matter, CHI bowed to public and political pressure to do so last week. 

These reports revealed that one child had returned to theatre 33 times with complications.

Speaking to The Journal, Michelle Long, co-founder of the Scoliosis Advocacy Network, said the group met with senior clinicians for CHI in recent days and learned that a separate report into surgeries at CHI Crumlin had been completed.

She said the group “first learned” of the Crumlin report last Monday in a briefing which took place to speak to advocates and parents regarding Temple Street.

Long said the Crumlin hospital review was commissioned to focus on a small number of patients following the formation of similar evaluation of procedures at Temple Street hospital.

“An internal review has been carried out in Crumlin but it has yet to be published. How are we sure what kind of service is currently underway in Crumlin, when the reviews at Temple Street were only published when pressure came on,” Long said.

“For an internal review you don’t have to contact patients,” she said, adding that the review instead is an audit of the hospital’s files.

“So we don’t know which children’s files are being looked at. It could be my child – we’re left to assume.”

Úna Keightly of the Spina Bifida and Hydrocephalus Paediatric Advocacy Group, said the group had spoken to CHI about the report in January but its members remained “very much in the dark”.

“We were given a commitment at a meeting with the HSE on 18 September that this would be published imminently and we’re still waiting. It needs to be released as soon as possible.”

Solicitor Raymond Bradley, who is representing a number of families affected in the Temple Street controversy through firm Malcolmson Law, said the Crumlin review needed to be released given there is “such disquiet” over paediatric services at present.

“Many of the patients from Temple Street have been transferred into the Crumlin system, and Crumlin has been subject to an audit which hasn’t been disclosed,” Bradley said.

“In order to allay those patients’ concern, the audit should be released promptly so that they know that the system is reliable.”

He added that there is a question mark over whether Crumlin can “withstand the additional pressure” from transferred patients.

Long said that the Scoliosis Advocacy Network has been part of a hospital group-wide forum which meets every quarter to discuss service issues but said that the review of Crumlin’s services had never been raised in those meetings.

“Every opportunity was there for us to be made aware of this but we have never been made aware of a review being carried out at Crumlin until last Monday.”

CHI has been contacted for comment.

Temple Street reviews

The Temple Street external review found that the majority of patients reviewed – 13 out of 16 – required additional surgery due to postoperative complications.

The two Temple Street reviews published last week do not deal with the issue of unauthorised devices – springs – being implanted into children. This issue will be dealt with in a separate report commissioned by CHI.

The Scoliosis Advocacy Network said families would refuse to cooperate in a further external review of CHI’s spinal surgery services – commissioned by the HSE and announced last week – unless the terms of reference were widened significantly. 

Minister for Health Stephen Donnelly is due to meet with advocacy groups on Friday.

However the Spina Bifida and Hydrocephalus Paediatric Advocacy Group told RTÉ Radio One’s Drivetime that it would reject the planned meeting and wanted to speak with the Taoiseach. 

Yesterday, HSE chief executive Bernard Gloster told This Week on RTÉ Radio One that communication with families “could have been better”, but he insisted that the review will not be paused.

Long said her group held a remote meeting with over 100 families yesterday from Temple Street and Crumlin.

She said they were “very angry” about the situation and fear delays it is set to cause to surgeries.

Long added: “The review needs to be far wider than medical issues. It needs to encompass licensing concerns, legal concerns, waitlist delays, management of waitlists. It’s far more than medical.

“There’s been an attempt to to have a narrative around one surgeon, one issue, instead of taking an opportunity to look at the wider piece when it is widely know that services have been in crisis for years and years.”

She said the HSE’s proposed review of of spinal surgeries at Temple Street – the third review so far in the controversy – will be “null and void” before it starts due to the boycott. She said today the terms “need to be redrafted” to include concerns by families.