Deputy Mary Lou McDonald- speech from 27 May 2025

Let's dive into the discussions shaping the nation. Taoiseach, the independent audit of hip surgeries at Children's Health Ireland and the National Orthopaedic Hospital, Capa, is damning. It makes for devastating reading for parents and families who are caught up in this scandal. One of those, a heartbroken mother, contacted us. Her daughter was just four when she had surgery on both hips. And this mother is convinced, based on her reading of the audit report, that her daughter did not require either operation. Here is what she wrote. I am gutted to have let my daughter down. I am the person who is supposed to protect her. I will have to live with that. After her operation, I will never forget what she said to me. I did not ask to come here, Mammy. She walked into that hospital, but had to be carried out. Learn how to walk again, night after night for weeks, screaming and crying from muscle spasms. Thank God she is now back to herself. I have no doubt that she will have those memories for life. And I have no words left, only tears. 2,200 letters have been sent to parents. And all of them now ask themselves the same question. Was my child put through the trauma of surgery that was not needed? Taoiseach, you had said that the response to this scandal would be to put the children affected and their parents first. But yet, families heard of the publication of the audit through the media. They were not provided with a copy before it was published. Parents also report that they are being fobbed off by the hotline set up to deal with their queries. And last night, parents received their first communication from the hospitals since this audit was published. A very blunt, very insensitive letter inviting their child to an appointment, and written in bold, stating that only one parent can attend. Who do these people think they are treating distressed parents like that? At a meeting on Sunday evening, parents expressed anger naturally and also deep, deep concern about the independence of review and assessment processes from CHI. They asked how can the very organisation that presided over this scandal have any involvement in any review? CHI was married in scandal and catastrophic governance failure, unnecessary hip surgeries on children, unauthorised springs in children's spines. We also hear that a CHI consultant was delaying treatment and referring public patients to his own private clinic, being paid thousands to the National Treatment Purchase Fund. The failure of government to immediately establish and put beyond any doubt the absolute independence of all of the expert panel has led now to a real fear amongst parents that this will be largely in-house within CHI. There has been no excuse for delay, Taoiseach. Your government have been aware of this scandal for an entire year. But your failure to prepare means that parents now face that cruel prospect of waiting months with stress and worry before they can find out if their child was operated on unnecessarily. The government now really needs to get its act together and do right by these families. So, can you guarantee that every child who has had these hip surgeries since 2010 will have their case review to determine if the operation was necessary? And crucially, can you assure parents that the expert panel will be entirely independent of CHI? Our But I just say at the outset that our overriding consideration will be the children upon whom these operations were carried out, and the families. That is the number one priority of government, and indeed of the Minister for Health. The findings of the audit are shocking, very, very grave, and our first thoughts have to be with the children and the family. In terms of the communications, and make sure there should not be a limit of one burden on any meeting, and in my view, parents or at least a mother or father may require support at such a meeting, and that should be readily facilitated. Would make the point the audit was external, so I think it is unfair to put aspirations on the government's motivations, suggesting that someone would be an in-house. The audit was external, conducted by Simon Thomas, consulted with an orthopaedic surgeon at Bristol Royal Hospital for Children. And in the figures, 60% of procedures in Temple Street, not clinically indicated in accordance with the criteria established by the author. In CAPA, 79% not clinically indicated. It is beyond comprehension, but we need to find out why, and how did that happen. But the most immediate priority has to be the follow-up for the families. And the individualized letters have been sent out by CHIM, by CAPA. And an expert reference group with international expert input is developing the criteria against which future multidisciplinary team assessments will be made, and that will be in place within the next two months. But in terms of the retrospective review, some, I mean, fundamentally, it has to be external, and a separate process involving external experts is being established for this purpose by the HSE. The Minister has asked the RCSI to assist in bringing together a multidisciplinary external team to examine all cases that were going back over the period of time in question, which allows for about a 15-year period in terms of skeletal maturity and so forth. The Minister for Health is expediting the establishment and engagement of external experts to review these cases, not just surgeons, radiographers, and other disciplines as well. The issues raised the most fundamental concerns about clinical performance itself, clinical governance, and, yes, overall governance within CHI. Other matters that the deputy referred to in respect of a report that was published in the Sunday Times. The Minister was notified of this Sunday afternoon, or Saturday afternoon, via media inquiry, had not been alerted to the existence of that internal inquiry report conducted by CHI. That too makes for shocking reading of the most profound kind, which not just goes to the heart of, in my view, the misuse of NTPF funding, but more seriously raises very fundamental concerns at that time about safety for children receiving surgery. Thank you, teacher. Thank you, Macdonald. I think it is now abundantly clear for anyone who wishes to see that clinical governance, governance in general at CHI, is absolutely a fiasco. I know that three members of the board have resigned to put it to the issue that the remaining members should follow suit, because clearly what is needed here now is root and branch reform and change, transparency and accountability. I voice these concerns around the independence of this reference group, the full independence of it from CHI, because that is the concern that parents are bringing to us. They have been catastrophically failed. Trust levels are on the floor. This involves perhaps unnecessary surgery on very, very young children. And every effort, if you are true to your word, that parents and children come first, then the absolute independence needs to be given. Can you give us that assurance? Can you assure us also, Taoiseach, that every child who had surgery since 2010, that every single case will be independently investigated and reviewed? The immediate priority is the clinical follow-up and care of patients who have undergone this surgery. And this does represent a very fundamental and serious breach of trust, the most fundamental breach of trust. And as I say, there will have to be further investigations in terms of why this occurred and how it was allowed to occur. And in terms of the retrospective look-back, I said it will have to be externally done, involving multidisciplinary teams to make sure that that independence and that confidence is in the process from day one. I will make the point, of course, that 98% of the procedures and surgeries within Crumlin were clinically indicated. And I would also make the point, there are many very good, high-quality people working in CHI generally too. That should be acknowledged. Thank you, Taoiseach. But there are very basic issues of clinical governance, clinical leadership, clinical performance, and indeed overall governance of the hospital that are clearly raised and emerged from this situation. Like, share, and subscribe, and let us know your thoughts in the comments. We'd love to hear from you.