A HSE internal audit has found Government funding of €19 million to reduce waiting times for spinal surgery at the Children’s Health Ireland (CHI) hospital group was used for the purposes intended, contradicting a claim by Minister for Health Stephen Donnelly.
However, the report found the targets of cutting the number of patients with conditions such as scoliosis and spina bifida waiting for longer than four months for spinal surgery “were not met”.
The audit was sought by Mr Donnelly, who said in the Seanad last July that the funding intended solely for spinal services had been allocated “far more broadly” across the CHI group, which runs paediatric hospitals at Temple Street, Crumlin and Tallaght.
The report, published by the HSE on Wednesday, said “no issues” were identified when auditors examined the allocation of funding.
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The audit said that in February 2022, following a presentation by CHI to the then taoiseach Micheál Martin, Mr Donnelly and senior officials from the HSE and the Department of Health, Government funding was committed to action plans to address waiting times.
The report said the plans involved recruiting more than 160 additional staff, the construction of a fifth operating theatre in Temple Street, the provision of two extra intensive care beds and facilities for a second MRI scanner in Crumlin children’s hospital, as well as the installation of 24 new beds across both sites.
The plans also involved outsourcing surgeries to private hospitals and the provision of HSE funding to the National Orthopaedic Hospital Cappagh in Finglas for surgeries.
The audit found that not all of the additional capacity provided was intended to exclusively benefit young patients with scoliosis and spina bifida.
“There is an expectation gap in the public domain regarding the purpose of the funding provided to CHI under the agreed plans. The perception that this funding would solely impact the patient group is inconsistent with some of the roles and their related intended purpose as funded under the agreed plans.”
The audit said the increased capacity had “varying degrees of impact” on the treatment of the patient group.
“CHI Management confirmed the addition of the new operating theatre resulted in five more orthopaedic theatre sessions per week and the new orthopaedic beds being used between 24 per cent and 41 per cent specifically by the patient group.”
However, it said the agreed plans also provided additional capacity for areas outside of the patient group.
“This included acute medical admissions and short stay observation beds which has no direct impact on this patient group. However, CHI management confirmed this capacity has an indirect impact by freeing up additional hospital capacity.
“CHI management confirmed that priority is given to the patient group in relation to some of the funded initiatives which includes accessing the new operating theatre, MRI scanner, orthopaedic and critical care beds.”
Mr Donnelly told the Seanad in July: “It is clear, from detailed discussions I had with the HSE and CHI, that the majority of the funding intended for spinal services was allocated far more broadly across CHI than for spinal services. While I have no doubt the allocation of that money into other services has been hugely consequential and important for the children involved, the majority of that money was for spinal services. This matter was raised with me by the advocacy groups.
“I am not satisfied that the €19 million was allocated according to Government priority. While I have no doubt it has all benefited children, I am aware that the 206 whole-time equivalents who have been hired are not all working – and are not all close to working – in spinal services.”
A spokesman for Mr Donnelly said on Wednesday that while the audit found that the money allocated was spent for the benefit of children, it had concluded that CHI did not prioritise children with scoliosis and spina bifida “as was clearly intended” by the Government.
“The Minister continues to work with the board and executive of CHI to address issues with the spinal service and this work will be continued by his successor,” the spokesman said.
CHI welcomed the publication of the HSE review.
Interim CHI chief executive Fiona Murphy, said: “Importantly, the review shows that a total of 989 surgeries were completed in Children’s Health Ireland under the spinal surgery plans 2022 and 2023; a marked increase in the numbers treated in previous years. Children’s Health Ireland continues to increase the capacity required to treat children and young people that need spinal surgery. As of 6th December 2024, Children’s Health Ireland has completed 499 spinal surgeries, this year.”
OrthoKids Ireland, an advocacy group representing children and families affected by delayed spinal surgeries, said it “unequivocally” rejects CHI’s assertion that the funding was used as intended.
“This statement is nothing more than an attempt to distract and divert attention from the core issue: CHI’s management and executive failed to spend public money as directed by the Minister for Health, and this failure has had devastating consequences for vulnerable children,” the group said.
“The HSE internal audit confirms that while there was no misappropriation of funds, the money was not spent as directed by the Minister. The audit reveals delays in recruitment and capital projects, underspending of allocated funds, and expenditures on initiatives that had no direct impact on scoliosis and spina bifida patients. CHI’s management and executive are responsible for this misalignment between the Minister’s directives and the actual use of the funds.”
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