Subsuming CHI into HSE will be one of options considered, says Bernard Gloster

By David Young, PA

The potential for Children’s Health Ireland (CHI) to be fully subsumed into the HSE will be one option considered amid concerns around clinical care and governance, HSE chief Bernard Gloster has said.

Mr Gloster was commenting on the steps open to Minister for Health Jennifer Carroll MacNeill as she considers how to respond to several controversies involving CHI.

The CHI hospital group is a distinct entity from the HSE, although it is funded by the HSE and able to it.

In the latest controversy involving CHI, last week an audit identified that many children underwent “unnecessary” hip surgeries in two Dublin hospitals.

The clinical audit of dysplasia of the hips surgery in children found that a lower threshold for operations was used at CHI Temple Street hospital and the National Orthopaedic Hospital Cappagh (NOHC) than the threshold used at CHI Crumlin.

The review discovered that in the period 2021 to 2023 almost 80% of children operated on at the NOHC, and 60 per cent of those at Temple Street, did not meet the threshold for surgery.

Mr Gloster said 2,259 children who underwent hip surgeries in the three hospitals (NOHC, CHI Temple Street and CHI Crumlin) from as far back as 2010 will now be subject to clinical reviews.

In an interview on RTÉ Radio One’s This Week programme, the HSE boss was asked if the issues highlighted by the report were down to bad decisions by doctors or a bad system.

“It can be a combination of any of those and rarely in a deficiency in a healthcare system will it come down to one single part of that,” he said.

Asked if there would be ability for individual surgeons, Mr Gloster highlighted that CHI and NOHC were the employers, not the HSE.

But he said the question of ability was “fair and appropriate”.

He said there were also questions about the governance of the institutions involved.

“In the midst of all of this most concerning situation there is no doubt that there are weaknesses in systems,” he said.

“There are weaknesses in governance, and that’s why the minister (Ms Carrol MacNeill) who has raised with me a number of times since her tenure commenced, she has raised with me concerns about aspects of CHI, not because there are individual incidents or instances – they occur in any healthcare system – but it’s about the collective of those.

“It’s about the governance response to them and the disposition towards them and the apparent inability to get on top of them.”

In April, the chairman of the board of CHI Dr Jim Browne resigned following the publication of a critical report into the use of springs in child spinal surgery.

The Health Information and Quality Authority (HIQA) found that the use of the springs, which were of a non-medical grade, was “wrong”.

The springs were used in three operations carried out by a surgeon at CHI’s Temple Street.

On Sunday, Mr Gloster was asked if the option of subsuming CHI into the HSE was being considered, he replied: “The minister wants to consider all of the options. And, of course, when she sets out all of the options, that has to be one that gets considered, but it is not the only one.”

Mr Gloster added: “The job of the executive, the job of CHI, the job of the doctors and everybody else today is leave the minister to do her job. She will do that very well and give us policy direction.

“We need to get on with looking after these children and with ing their families.”