HOW COULD THIS HAVE HAPPENED?? Deputy Mary Lou McDonald- speech from 13 May 2025

Welcome to Leaders Questions I want to offer condolences to everyone who loved Garda, Kevin Flackley, to his heartbroken wife Una and their two children, Aoife and Erin, his parents, his family, his friends, and of course to his colleagues within Garda this year, Kona. He was a devoted father, a man with a deep draw for community, a GAA man, his beloved club O'Dwires in Balbrigan, and his death is a devastating reminder of the dangers faced by the Gardaí as they keep us safe. So, the good man is lost to his family, a great Garda is lost to his community, and the country mourns with them. Thaiseach, the controversy regarding unnecessary hip surgery carried out on children at CHI Hospital has deepened, deepened. The Minister for Health has now finally confirmed that parents are receiving letters about operations on children as far back as 2010. This is the first confirmation from Government that this scandal goes back at least 15 years, and not the two-year period as previously asserted by Government. We have been raising this issue with you and with the Tánaiste for weeks now. We did so because we had been contacted directly by parents, literally at their wit's end, having received letters from CHI regarding operations their children had 15 years ago. We have been raising it with you, conscious of all of those parents who are now asking themselves, was my child operated on unnecessary? How could this have happened? And what are the consequences now? And each time you have been questioned on this scandal, you and Simon Harris have responded with non-answers. You have refused to give clarity, and so parents have been stonewalled by CHI and stonewalled by your Government. So after weeks of trying to contain the truth, we have it finally in black and white from the Minister for Health, confirmation that letters have been issued to parents of children who had operations 15 years ago. The Minister's response to CHI, David Cullinan, states, letters were issued to families and patients who had hip dysplasia procedures since 2010 to provide reassurance and information, she says, about the audit and to ensure all potential cases are included. But Taoiseach, the truth is you have given neither information nor reassurance to parents. In fact, you have been ducking, diving and dodging. The Minister has now accepted that there are cases going back to 2010, which means the investigation is not limited in the way that your Government had previously claimed. In fact, it stretches back 15 years at least. So if the 2021 to 2023 audit recalled 561 children, this we know, Taoiseach, can I ask you, how many children in total are subject to recall in the full look-back process? Is it hundreds? Is it thousands? What's the number Taoiseach? The Minister for Health also says that an action plan is being prepared. She states, the plan will include identification of groups of patients not included in the audit sample, but who may be affected by any findings of the audit. Can you explain to me exactly what that means? And can you tell parents sick with worry, who may be listening today, what precisely all of this means for their children? The parents of children caught up in this hip surgery scandal deserve answers and the full truth. Now we know that this scandal goes back 15 years at least. Can you finally tell us how many letters have been issued to parents? How many children have been recalled? Does this go back even further than 2010? How many children are involved? I would like to extend my deepest sympathies on the floor of the House to the family, friends and colleagues of Garda, Kevin Flatley. Our thoughts and prayers are particularly with his wife, Una, and his daughters, Aoife and Erin. He died in the line of duty and a reminder to us of the dangers that members of Angiarda Shikana go through day after day as part of their mission to keep us all safe and to prevent crime. He was an outstanding community person, as many Garda are, not only give duty in the line of service, but outside of their duties as members of the Garda Shikana. They are pillars within our community, helping sporting organisations, in this case Kevin helping O'Dwyer's GA club. We extend our sympathies to the broader force, as well as all members of Angiarda Shikana, at what is a very difficult and traumatic time for them, and a huge blow to the force. In respect of the clinical audit that has been conducted, in respect of developmental dysplasia, I think in the first instance it has to be said that there is a lot of anxiety and concern. Again, a lot of parents would be worried, because for a child to go through an operation or surgery is very traumatic for a child and very traumatic for the parents. Anything we do in here must be done with that in mind. That we are very conscious of anxiety that can be added to or created by anything we say, or by piecemeal information, or by drip-drip feed in respect of this issue. The Minister has taken the correct decision in terms of establishing a clinical audit by an external international expert on surgery for children with developmental dysplasia of the hip across the CHI and the National Orthopaedic Hospital in Capa. As you know, that audit was carried out after concerns were raised that different standards and surgical practices were being used for DDH in CHI Temple Street and Capa. And the purpose was to assess whether the standards and surgical practice used at CHI and Capa were in keeping with international standards of practice. Concerns had been initially raised under a predicted disclosure in September of 2023 and the Department was notified on the 9th of May of 2024. There was some delay to the starting of the audit as the surgeon who had originally agreed to carry out the audit was no longer able to. And therefore it was necessary to secure the expertise of another paediatric surgeon. The clinical audit has been carried out or conducted, was conducted on a random anonymised sample of patients aged one to seven years of age who had these procedures from 2021 to 2023 in CHI and indeed in Capa. The audit process is now at a very advanced stage. It's understood that the audit author has received final feedback and fact checking from the clinicians to whom the draft report was circulated. We all know that is a standard procedure in respect of audits of this kind. And we don't have a final timeline in terms of from the HSC or the CHI and when the report will be fully complete and provided to the minister. Now pending completion of the audit report and as a patient safety precaution, all DDH cases are now being reviewed by a single team of clinicians from CHI and Capa before any decision for surgery is made. And this process has been in place since July of March 2005. You're correct, an action plan is currently being drafted in advance of the final audit report. And this plan includes the identification of groups of patients not included in the audit sample, but who may be affected by any findings of the audit. And plans are being put in place for patient follow-up in line with good practice and will of course consider any recommendations with regard to clinical follow-up from the final report. And CHI and CHI and Capa have issued letters in recent weeks to families and patients who have had hip dysplasia procedures since 2010 to provide reassurance and information about the audit and to ensure all potential cases. Those letters went out after media reporting of a draft audit report. And it was found necessary after that to communicate to parents as a result of a draft report. The minister can't comment on that because the minister hasn't received a report. And it's critical that the minister would get that. And we can go back later in the last minute. But the fundamental point here is no one's ducking and diving or dodging anything. And it's unfair to suggest that. We want completion. It's far better for everybody. But the complete report is issued and published. And then we can... Thank you. Thank you, Mr. Deputy McAllister. So the anxiety of these parents could not be overstated. As you've correctly noted, he shook the initial sample between 2021 and 2023 as children between the ages of one and seven. These are very, very young children. And the idea of any small child being operated on unnecessarily is extremely traumatizing for their parents. But their anxiety has been added to by your absolute lack of clarity. And even now, today, your refusal to answer just basic questions of information. How many letters have been issued and how many children are involved? The parents concerned want to know that. You wrote... The system wrote to these parents. They have raised this issue with these parents for their children and in these families. And now, having raised the issue, no clarity is given. No reassurance has been given, Taoiseach. That's the truth. So can we start the process of clarity today? Can you simply tell me how many letters have been issued? How many children will be recalled? You ought to know that as Taoiseach at this stage. If you don't mind me saying so, Deputy, I think you're being somewhat disingenuous here. Nobody is stonewalling, no one is refusing to get information. I thought the obvious thing to do, and we may have this sooner than you might think, but the obvious thing to do is to wait for the audit report to be published and given to the Minister. That's logical. Otherwise, all you're asking for is drip-drip, bits of information here and there, which only adds to the anxiety and concern of parents. Yes. And I think, if I may, I haven't interrupted it. To me, an experience tells me that when you ask someone to do an external audit, independently of politicians and of government, just let them finish their work and have the totality of their work available for us to assess and then to take action based on that. That, to me, would, and of course, that audit has to be shared with the public, with the parents in the first instance and the patients. Because there was always a follow-up of children who have surgery for this particular condition. And that follow-up would take place right into their teenage years, right into 14 or 15 or 16. Yeah, but if you then understand therefore the context, you clearly then understand the context of why this would be written. Deputy Ivana Bacic. Like, share, and subscribe, and let us know your thoughts in the comments. We'd love to hear from you.