Martin Daly presses for accountability over spinal surgery failures
Martin Daly addressed systemic failures in the care of children with scoliosis and complex spinal conditions, commending the minister's establishment of inquiries while demanding transparency and better governance. He urged expansive but focused terms of reference, faster treatment, improved clinical governance and that patients' and families' voices shape reforms.
Focus on children with scoliosis and spinal care
Martin Daly opened by centring children and parents who have endured long waits, uncertainty and, in some cases, devastating medical outcomes. He said the system's past response to families' concerns has often been defensive and paternalistic and that those experiences must remain central to legislative and policy responses.
Clinical review findings highlighted in the speech
He summarised clinical reviews of complex spinal surgeries carried out between 2.18 and 2.22 that identified extraordinarily high complication rates, including infection rates exceeding 70% and a majority requiring repeat surgery in one cohort. Further investigations exposed governance failures, problematic use of implantable devices lacking appropriate regulatory improvement, and shortcomings in oversight, documentation and ethical processes.
Calls for accountability and inquiry scope
Martin Daly praised the minister for establishing processes including statutory public inquiries into CHI and the Michael Schein case, and non-statutory inquiries into harm from sodium valparate prescriptions. He argued the inquiry scoping must be expansive enough to assuage public concern yet focused enough to identify issues without obfuscation, and that inquiries must establish facts and consequences while respecting due process.
Progress demanded alongside ongoing inquiries
While acknowledging steps taken in the past 12 months — including addressed governance, expanded capacity through domestic and international outsourcing, ring‑fenced surgical time, and a spinal surgery management unit and ministerial taskforce — he insisted that investment must deliver timely access, shorter waits, safer governance structures and audited, transparent performance.
Role of clinicians, families and future reform
Martin Daly stressed the need for a healthcare culture that empowers staff to raise concerns early, encourages multidisciplinary collaboration, and places patient safety above all. He emphasised that the voices of patients and families must continue to shape reforms and that lessons from these failures must lead to lasting change for children and all patients who entrust their care to the health service.
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Minister, I want to start by acknowledging your statement. You have dealt with the issues of surgical mismanagement of children with scoliosis and hip dysplasia and CHI, the sodium valparate injury cases and the Michael Schein abuse case in an open and comprehensive manner. You have established the process that Senior Councils Farrell and Staines will establish, the statutory public inquiries into CHI and Schein, and the ongoing non-statutory inquiries into the harm done to pregnant women and children who prescribe sodium valparate. I commend you on your commitment to the ongoing audits of the Developmental Dysplastic Hip Review and Phase 2 of the GIAM report. I first want to address the care of children with scoliosis and complex spinal conditions. At the centre of this discussion are children and parents who have endured years of uncertainty, long waiting times, and after all of that, in some cases, have had devastating medical outcomes in a system that would appear to have been dysfunctional with the failure of organisational and clinical governance. The response of the system to families' concerns and distress has been, in the past, defensive and paternalistic. Their experiences must remain at the heart of how we respond as legislators and policy makers. The inquiries must establish the facts and the consequences of those facts. Notwithstanding due process and natural justice, these inquiries have to be acute in their examination of how and why we arrived at this juncture. Over the past number of years, a series of reviews and investigations have highlighted serious shortcomings within the system. Clinical reviews of complex spinal surgeries carried out between 2.18 and 2.22 identified extraordinarily high complication rates, including infection rates exceeding 70%, and the need for repeat surgeries in a majority of cases within one cohort. These findings have understandably shocked families and the wider public. Further investigations also exposed significant governance failures, including the use of implantable devices that did not have the appropriate regulatory improvement, and also shortcomings in oversight, documentation and ethical processes. We must be clear, when failures occur in healthcare systems, particularly when they involve children, transparency and accountability are essential. Families and citizens deserve answers, and they deserve assurance that lessons are being learned. That inquiry process is now entering a scoping phase, which will help determine the terms of reference and structure required to fully examine what went wrong and how to prevent it from happening again. But the terms of reference need to be expansive enough to assuage public concern, and focused enough to identify the issues without obfuscation. As we wait for the outcome of these historical inquiries, we must strive forward to improve care for patients currently waiting for treatment. Minister, you have driven change in the last 12 months with zeal. Governance issues have been addressed with wider and more inclusive decision-making. Capacity has been expanded through domestic and international outsourcing arrangements. Additional surgical time has been ring-fenced. A spinal surgery management unit and ministerial taskforce, your taskforce, has been established to oversee progress, and that must be acknowledged. But with this investment, we must see progress with timely access and interventions in a high-quality environment with robust systemic and clinical governments. We must rebuild trust with performance that is audited and transparent. Families must see real change, shorter waiting times, shorter oversight, safer governance structures, and better communication from healthcare providers. We also need a healthcare culture that empowers clinicians and staff to raise concerns early, encourages multidisciplinary collaboration, and ensures that patient safety is always the overriding priority. Most importantly, the voices of patients and their families must continue to shape the reforms we implement. Ireland is fortunate to have highly skilled clinicians and healthcare professions who dedicate their lives to caring for children. However, we must have systems that support their skills, that delivers care that is robust, transparent, and accountable. Our responsibility in this House is to ensure that lessons from these events lead to lasting change. We've had too many inquiries, too many failures. We owe that to the children affected, to the families who fought tirelessly for service and for answers, and to every patient who places their trust in our health service. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith. Go raibh maith.
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