1. Hip Surgeries (Children’s Health Ireland)
A major scandal has emerged over pediatric hip surgeries performed at Children’s Health Ireland (CHI) hospitals, particularly Temple Street and the National Orthopaedic Hospital, Cappagh. An independent audit was published in May 2025 regarding hip surgeries performed to treat Developmental Dysplasia of the Hip (DDH).
The Findings
The audit revealed that a significant number of surgeries performed between 2021 and 2023 at Temple Street Children’s Hospital and the National Orthopaedic Hospital, Cappagh, did not meet the standard clinical criteria for intervention.
- Temple Street: Approximately 60% of the reviewed cases did not meet the threshold for surgery.
- Cappagh Hospital: Nearly 80% of the reviewed cases did not meet the threshold.
- Crumlin Hospital: In contrast, surgeries here were largely found to be appropriate (98% met the criteria)
The Issue
The audit suggests that many children underwent “unnecessary” invasive surgery, potentially exposing them to avoidable pain, long recovery times, and surgical risks.
Recall of Patients
As a result, approximately 500 children who had pelvic osteotomy surgeries at these hospitals between 2021 and 2023 are being recalled for independent clinical review and radiological assessment.
Wider Review (2026)
In November 2025, the HSE confirmed that an External Expert Panel (EEP) will review surgical decisions dating back to January 2010. This massive review is scheduled to begin no later than January 2026 and is expected to take at least 12 months to complete.
Systemic Failures: This issue highlights broader systemic failures in governance, clinical practice variance, and a lack of robust multidisciplinary team decision-making for complex procedures. Read More
2. Child and Adolescent Mental Health Services (CAMHS)
CAMHS has been a persistent area of concern, plagued by systemic issues that have left many vulnerable children and young people without adequate and timely support.
1. Sub-standard Care in South Kerry: The Maskey Report, published in January 2022, found that the care received by 240 young people did not meet necessary standards, identifying deficits in governance, supervision, clinical practice, and overall functioning. Read More
2. Sub- standard care in North Kerry: The Halpin Report was commissioned by the HSE in 2023 following a random audit of open cases in North Kerry CAMHS in 2022, which raised concerns about the quality of care. It was prompted by the earlier Maskey Report into South Kerry CAMHS, which revealed significant issues, including the incorrect treatment of many children and the prescription of unnecessary medication. Read More
3. Nationwide- “Lost” Cases and Lack of Follow-up:
An interim report by the Mental Health Commission (MHC) in January 2023 highlighted that children and young people with open CAMHS cases were “lost” to follow-up care, with some not having appointments for up to two years. This included instances of young adults transitioning to adult services without proper planning or medication advice.
- Deficits in Care and Governance: The MHC report also identified significant deficits across many CAMHS teams, including staff working beyond contracted hours, stress and burnout, and a lack of governance, leading to inefficient and unsafe services. This includes failures in risk management, funding, recruitment, and service standardisation.
- Long Waiting Lists and Inconsistent Care: There are long waiting lists for CAMHS services, wide variations in acceptance rates, and unacceptable inconsistencies in the quality of care provided. Capacity issues hinder the provision of appropriate therapeutic interventions, and there’s a lack of emergency and out-of-hours CAMHS services.
- Increased Demand and Staff Shortages: Referral rates to CAMHS increased by 33% between 2020 and 2021, exacerbating existing capacity challenges and staff shortages. Significant investment has been made, but deficits in access, capacity, and consistency persist. Read More
3. Spinal Surgeries
Issues within spinal surgeries, particularly for children with scoliosis and spina bifida, have also drawn considerable negative attention.
- Unauthorised Implants and Patient Safety: A damning HIQA report in April 2025 revealed that unapproved, non-CE-marked metal springs were surgically implanted into a number of children undergoing spinal surgery at CHI at Temple Street between 2020 and 2022. These springs were made of a material not intended for surgical use.
- Lack of Informed Consent and Oversight: The report found that documentation and information provided to families were “wholly inadequate” to describe the procedures, breaching the HSE National Consent Policy. It highlighted failures in procurement, decontamination, and communication processes, as well as complex governance structures with unclear lines of accountability.
- Missed Targets and Unspent Funding: An internal HSE audit revealed that children’s hospitals performed almost 200 surgeries below target for children with spinal issues between 2022 and 2023, despite improved funding. Over €13 million in allocated funding for these surgeries was not spent, with a significant portion of it related to additional staffing for CHI hospitals.
- Operational Delays: Shortfalls in completed surgeries were attributed to factors like the consultant’s extended leave and delays in opening new operating theatres. Projections for reducing waiting times for spinal surgeries were not met. Read More
Other areas of serious concern regarding services for Children
Assessment of Needs (AON)
The Assessment of Needs process, designed to provide timely assessments for children with disabilities, has been a source of ongoing legal and operational challenges for the HSE.
- Growing Waiting Lists and Delays: Despite legislative requirements, there are continuous backlogs and growing waiting lists for AON. As of May 2025, the HSE projects the waiting list could grow by an additional 25,000 people by the end of the year. Over 14,000 children were waiting for an assessment in February 2025, with many waiting over a year for initial contact.
- Legal Challenges and Legislative Amendments: A High Court ruling in 2022 determined that assessments needed to be more comprehensive (over 30 hours), impacting resources. While the HSE accepted this ruling and changed its assessment model, government officials have expressed regret about not amending the legislation sooner to allow for the previous model.
- Resource Strain: The demand for AON continues to grow annually, with a 20% increase in the last year. Completing the projected number of assessments would require a significant number of full-time clinicians, diverting resources from therapeutic supports.
- Systemic Failure to Fulfil Legal Obligations: Parents of children affected are of the view that the laws concerning AON are being systematically breached by the government and the HSE, leading to significant stress and delayed access to essential services (such as speech therapy and special education) for children with additional needs and their families. Read More
