The release of an independent review of spinal surgeries carried out at Temple Street Children’s Hospital has been pushed back following the identification of 17 new “cases of concern.” The UK expert leading the investigation, Selvadurai Nayagam, has expanded the investigation to include cases at Children’s Health Ireland (CHI) and the National Orthopaedic Hospital Cappagh.

This decision effectively doubles the number of procedures under scrutiny. The investigation was launched by the HSE last September after a number of serious surgical incidents were uncovered through an internal review. These incidents include the death of a child, post-op complications in others, and the unauthorised use of particular springs in three surgeries.

The consultant under review was involved in all of the additional cases flagged as concerning by CHI. He has ceased involvement in the most complex spinal surgeries since August 2022 and stopped performing all surgeries in July. When the internal reviews were made public last September, he availed of voluntary leave.

CHI has been instructed by Minister for Health, Stephen Donnelly, to set up a dedicated paediatric spinal surgery unit, following discussions with orthopaedic surgeons who emphasized the success of such units internationally. David Moore, head of orthopaedics at Crumlin Children’s Hospital and Tallaght University Hospital, will lead the unit. Additionally, the HSE has been directed to take on a full-time project lead to tackle unacceptably long orthopaedic waiting lists for children.

In response to calls from various advocacy groups, Minister Donnelly plans to create a task force on children’s spinal surgery waiting lists. These groups’ input is being sought to establish potential terms of reference. Timely spinal surgeries are crucial for children, as their issues can worsen rapidly while they are growing, causing further complications and acute pain.

At the end of 2023, 78 children had been waiting over four months for their spinal surgery, representing a 13% decrease from 2022. Despite a 5% decline in the overall number, 231 children were still on the waiting list at the close of the year, an ‘unacceptable’ number, a spokesperson from the Department conceded.

The initial report by Mr Nayagam, originally due by the end of 2023, now faces delays due to the expanded scope of the review, including the addition of cases from Cappagh. Advocacy groups have been informed that the timeline for publication has changed.