Miriam Lord: TDs call children’s spinal surgeries ‘one of the worst medical scandals in the history of the State’

After rumours allegedly doing the rounds for nearly two years, whistleblowers mustering, leads not chased up, internal reports, Dáil questions, a media exposé and one mystery letter, the cavalry arrived with words of comfort.

“I am determined we will get to the bottom of it,” the Taoiseach declared in the Dáil, voice solemn as the face of the Minister for Health sitting next to him.

“We need to come at this from a sensible, level-headed, calm, considered approach and make sure no one jumps to conclusions until we know all the facts,” Leo Varadkar told Sinn Féin’s Mary Lou McDonald during Leaders’ Questions.

He was talking about the shocking revelations which came to light last week about spinal operations carried out at Crumlin children’s hospital, sparking an urgent inquiry ordered by the Minister for Health, Stephen Donnelly, and his department which has been completely on top of this issue since he returned from his trip to New York at the weekend.

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Two reports – internal and external – are in the pipeline. An Oireachtas committee is primed and ready to go on Thursday.

The stones in the street are already turning themselves over in a gesture of co-operation with the Government.

On Wednesday, the Sinn Féin leader could have ambushed him with a sensational letter on the floor of the Dáil during Leaders’ Questions, but she didn’t. Instead, Mary Lou informed the House that she “shared” it with him earlier in the day.

This letter would seem to indicate that management and clinicians at the hospital were aware as far back as 2020 that experimental non-approved medical devices were being considered for implantation in patients.

This letter which came into her possession “seems to confirm” weekend reports that meetings about these experimental techniques took place at a very high level in the hospital, which was “far from being in the dark” on the issue.

It suggested that the head of Children’s Health Ireland (CHI) was involved in these meetings, which went as far back as 2020.

Fortunately for the Taoiseach, this was not to be his second bolt from the blue in recent days.

He told People Before Profit TD Paul Murphy on Tuesday that he was “shocked” when he heard “definitively” in the last week or so that non-medical grade devices were used in surgery.

Until then he was only startled.

While investigations into spinal operations were continuing in Temple Street, Donnelly says he only found out on August 4th about the use of unauthorised spring implants. In the meantime, certain surgeries at the hospital had been suspended since November pending the results of internal and external reviews.

Deputy Murphy started asking questions after he was told in April about what was going on. He tabled parliamentary questions to the Minister for Health in May and June.

The first asked if “all implants used in spinal surgery for patients with spina bifida and spinal muscular atrophy across Temple Street and Crumlin Hospitals are appropriately licensed”.

The second asked the Minister to outline the complication and re-operation rate for spinal operations in Temple Street and if implants had anything to do with this. He wanted to know if the devices were licensed for this particular use and who supplied them.

The fourth time, in July, he tabled three questions along the same lines.

In each case, he got back a stock reply. “As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.”

He heard nothing back.

Although he did get responses from CHI that everything was grand on the spinal implant front “to the best of its knowledge”.

Then on July 5th, Murphy asked the Taoiseach (a medical doctor) in some detail about these specific surgeries, their suspension, the ongoing reviews and the reason for them. He said it was imperative that reviews be published.

As he hadn’t seen the reports Leo wouldn’t “make a commitment on the hoof here in the House”. But he imagined the children’s parents would be very anxious to see them.

And he would “certainly” let the Minister know that the matter was raised in the Dáil chamber.

Again, Paul heard nothing back.

How long would he have had to wait had the Ditch website not lifted the lid on the goings-on?

Anyway, there are reviews and investigations now to beat the band.

[ No clinical concerns about spinal surgery outcomes at Crumlin, health bosses say ]

In fairness to Stephen Donnelly, he can’t be expected to wade through the morass of questions tabled in their thousands by TDs and Senators. That’s why he has staff, permanent or otherwise.

And also, he said on Tuesday, Deputy Murphy’s first couple of questions were kinda... vague?

But were they? The questions seemed specific and there were already issues to do with spinal surgery under scrutiny at the hospital.

Children, suffering and in pain. Concerns over patient safety going back to at least the middle of last year. Rumours circulating. A TD asking pointed questions. Danger here!

At this stage, after all the years of scandals and subsequent bouts of government breast-beating in the Dáil chamber, could they not rig up some sort of advance warning machine in the department which flashes red and sets off a klaxon when certain trigger words are picked up?

So what happens now, wondered Mary Lou McDonald. Her bombshell letter “raises fundamental questions of fact that need to be answered urgently and directly by Childrens Health Ireland”.

First off, the Taoiseach urged politicians, public and the media not to come to any conclusions until the full facts are known.

He will get to the bottom of this story.

He read the letter she sent and admitted it “puts a new complexion” on things, while being careful to stress he didn’t know if it was “genuine... ever actually sent... received... acknowledged, and I don’t know if you know those things either”.

But allowing for the fact that it might be a ready-up (unlikely), the letter “does indicate that there was a level of knowledge at management level about what was happening... and that the families and parents involved consented to what were essentially experimental procedures in very difficult cases”.

By late afternoon, the word from the top at CHI was that the chief executive has no record of ever getting the letter and it is now the subject of an independent investigation.

All the reviews in full swing.

Now all we have to do is wait.

This is something young spinal surgery patients and their families are well used to doing.

Nobody, not least the Taoiseach, batted an eyelid when the Sinn Féin leader routinely referred to what happened to these children as a scandal.

In the first full week of debate about it in the Dáil, deputies were already describing it as one of the worst medical scandals in the history of the State.

Horrendous.