SINN FÉIN LEADER Mary Lou McDonald has said that Children’s Health Ireland (CHI) and the HSE should have no role in “shaping the terms of reference” of the independent review into the children’s spinal surgery crisis at Temple Street.

Speaking at the Irish Hospital Consultants Association (IHCA) conference today, McDonald said that now is the time for the Taoiseach and the Health Minister to “take the lead, and take on the responsibility” of ensuring the review is fully independent.

It is understood that Health Minister Stephen Donnelly was invited to the consultants’ conference today, but has not attended as he had a diary clash. 

McDonald said that Donnelly urgently needs to take the lead on the Government’s response to the spinal surgery crisis.

“We need a fully transparent response, that means terms of reference that allow for a full systemic review. CHI and the HSE cannot shape those terms of reference, and the external review cannot report back to either body,” she said.

McDonald said that the best outcome of the review would be “justice, accountability, and some level of comfort for those injured children, and a family who have lost a child”.

She added that long-term, intervention needs to be focused on ending the “scandalous and agonising wait” that families and children with Spina Bifida and scoliosis have endured.

On Thursday, the Oireachtas Health committee heard that long waiting times for children’s surgeries led to children’s conditions and the resulting surgeries they underwent becoming more complex.

The HSE has commissioned an external review – which will be carried out by an independent expert – after two initial reviews found that 19 children experienced an increased rate of post operative complications and infections after undergoing spinal surgery at Temple Street last summer.

There were two serious incidents resulting from these complications, and one child who was involved in the reviews has lost their life.

An investigation has also found that that three children had non-medical grade, unapproved devices were implanted in three children (which have been described as “springs” attached to metal rods that are inserted into children’s spines.)

The CEO of CHI, Eilish Hardiman, revealed on Thursday that she stepped back from her involvement in shaping the terms of reference for the external review into the surgeries that were carried out in Temple Street, after it emerged that two clinicians emailed her in 2020 with a summary of a meeting, which flagged concerns about using experimental techniques in children’s surgeries.

Hardiman insisted that she never received the email, and only learned of its existence last month. She also said that her staff have not been able to locate it in her email inbox.
Prof Robert Landers, IHCA President, also called for a change to the terms of reference for the external review into spinal surgeries.

He said the focus of CHI reviews have been “regrettable”, and said that a “full systemic review” is more important that portioning individual blame.

He told the conference that consultants are often dealing with hugely complex cases – made more complex by long waiting times – while depending on outdated equipment and infrastructure.

Landers added that it is essential that going on from the spinal surgery crisis, consultants and surgeons still feel “supported” in taking on time sensitive and complex cases.

McDonald, Landers, and Labour leader Ivana Bacik discussed hospital capacity and recruitment of staff during this “critical juncture” for the health service at the conference.

Both Bacik and McDonald said that they are concerned about continuing reliance on private hospitals to plug the gaps in the public health system.

Landers and the party leaders took opposing views on the low uptake of the public only consultants contract.

Landers said that he is not surprised by low uptake:

“We’re running at less than ten percent off the top of my head, it comes down to some small tweaks that could have been made before that contract was finalised, that weren’t made. It also comes down to a question of trust between consultants and their employers.”

McDonald said that Sinn Fein would not have changed the current public only consultant contract on offer.

“In terms of rights that consultants have, their contractural obligations have to respected.

“I’d prefer if people embraced the public contract. I will say, the conversation around the contract has involved, unhelpful assumptions that all consultants care about is there level of financial return, I know that’s not true.

“My preferred form of contract is the current public contract as agreed. I believe in a public system, properly resourced and funded, but that does not stand in the way of developments in the private sector,” she said.

The ICHA’s annual report found a record breaking number of empty consultant posts at the start of June (933) – which it says is causing serious delays to patients’ treatment.

The specialists with the largest percentage of permanent consultant posts either vacant or filled on a temporary basis include intensive care medicine, psychiatry, medicine, obstetrics and gynaecology, radiology, pathology, paediatrics, surgery and emergency medicine. 

“The fact that so many Consultant posts remain vacant should be an unequivocal signal to Government and Health Service Management that the current conditions in hospitals do not create and environment in which skilled medical and surgical specialists want to work and which is driving our trained specialists abroad to pursue their careers,” the report said. 

The report said that a survey of ICHA members found that 69% of consultants “experienced symptoms of burnout due to work pressures in the past 12 months”.