THE man charged with ending the waiting list nightmare for children in need of spinal surgery has told how public anger has “blown away” the resource shortages which created the mess in the first place.
CHI spinal lead Dr David Moore today opens up on the problems that led to the lengthy wait lists, how CHI is trying to rebuild public confidence and the toll this has taken on healthcare workers.
In an interview with the Irish Sun, he said: “I think the system was under resourced.
“There is no doubt absolutely there was a need for somebody to throw all the toys around the place and say this is not good enough.
“I think we’re getting there. I certainly wouldn’t be happy to say we’ve done the job. We haven’t. We’re doing the job. We’re not there yet.
“I think that we will get there but there will always be waiting lists.”
Children waiting too long for spinal surgeries for conditions such as scoliosis and spina bifida has scarred the health service for years.
In 2017, then Health Minister Simon Harris vowed that no child would wait longer than four months for an operation, but this failed to happen.
In 2022, health bosses again made this commitment to Health Minister Stephen Donnelly who allocated €19m – but this plan also failed, according to the Minister.
In response, a new dedicated spinal unit was set up, with orthopaedic surgeon Dr David Moore asked to lead the team and get on top of the waiting list issue.
Sitting in Crumlin Hospital, Dr Moore tells the Irish Sun that a lack of resources led to these long delays for children.
He said: “Historically we didn’t have the resources to deal with the demand.
“The demand got greater because of the population increase, patients expectations, technology – we have the ability to do more now.
“Our non-orthopaedic colleagues have become really very good at making very, very sick and unwell kids fit for surgery so that’s a cohort of patients that maybe in the past wouldn’t have been able to have surgery.
“That kind of speaks to just how complex some of them are.
“Covid made things worse. It didn’t cause the problem but it made it much worse because we weren’t able to do as much surgery – like all the other disciplines.
“That was ultimately the straw that broke the camel’s back.”
These delays came not just from surgical capacity but also in the services needed to get a child ready for an operation such as an MRI under general anaesthetic, breathing tests and the ICU beds needed after the surgery.
However, following public outcry and political pressure Dr Moore says that lack of resources has been “blown away” as the Government gives his team funding for almost anything they ask for.
On the day of our interview, Dr Moore had just received the green light from the Minister for funding for 29 more nurses, five more consultants and a new scoliosis spine register – a tool to help gather information about surgeries that will cost €380,000 a year alone.
‘BIG CHANGE’
He added: “When I started here there were three orthopaedic surgeons. We’re now at nine and by the middle of next year we’ll have 12 here plus there will be at that stage seven if not eight in Temple Street.
“So when we move to the new hospital next year hopefully we will have in the low 20s – that is a big change from six 15 years ago and that is where historically our waiting lists came from.”
The latest CHI update shows that there is a total of 259 children waiting for surgery with this number falling slightly for the last three months in a row.
Figures from the Department of Health this week show there are 107 kids on the “active wait list” – meaning they are ready for surgery but have not been given a date.
PROJECTIONS PRESSURE
Both the Minister and Taoiseach have put out projected figures that this “active wait” list will fall to 87 by Christmas and the number of kids waiting longer than four months will drop to 20.
Dr Moore admits that his team are “pressurised to give them projections” and says “if we don’t meet them it won’t be for the want of trying”.
However, the lead surgeon warns that a difficult winter season for our hospitals could see all these projections go “out the window”.
Our Kids Can’t Wait Campaign
WAITING lists in Ireland have long been a national disgrace.
More than 106,000 children are on hospital waiting lists for all treatments. However, a new source of shame has emerged as 327 children wait for life changing spinal surgeries.
Their conditions are getting worse while they languish on waiting lists.
Such are the delays, many child patients will be outside the therapeutic window when their treatments are approved.
Earlier this month, the Seanad heard how at least one child has become permanently paralysed since the issue was raised publicly before Christmas.
Their plight has been spearheaded by campaigning Senator Tom Clonan, who himself has a child with a disability.
Former Taoiseach Leo Varadkar has even admitted that the health service is failing these kids.
Children are being allowed to deteriorate due to mismanagement, which has allowed the waiting lists to grow.
The Irish Sun’s Kids Can’t Wait campaign aims to shine a light on how the State is failing sick children and give their families a voice.
It will also force the Government to do something to clear the backlog of operations and give these children a chance of living a normal life.
He said: “That is where the projections go out the window if that happens.
“There is lots of people now you will see with sniffles and coughs and some people get more than that.
“Kids get very sick. They come in and might need ICU and therefore some of our more complicated patients might get cancelled because we don’t have an ICU bed for them.
“That is a definite possibility.”
As part of the drive to get on top of the waiting list, capacity has been acquired from other hospitals in Blackrock, the Mater and Cappagh while 20 children are also being sent overseas for operations in New York and London.
‘GETTING MUCH BETTER’
However, Dr Moore believes that overseas capacity may not be needed as soon as next year when he feels the Irish system will be better able to cope.
He said: “I don’t think we will have 20 kids going abroad next year.
“I think we will be on top of it. I think we’re getting much better at the numbers we’re doing.”
Minister Donnelly has been focused on what he calls the “long waiters” – the number of children waiting longer than four months for surgery.
Dr Moore does not agree with the four month target which he labels “a stick the HSE gave themselves to be beaten with”.
He explains that every child is different so the four month target may not apply.
He said: “What we want is that we are able to operate on kids in a clinically appropriate time frame – that’s all we want.”
Dr Moore makes a point in our interview of highlighting the needs of children with non-spinal orthopaedic conditions.
This is children with conditions like hip dysplasia or crooked feet or even broken bones which all need orthopaedic care.
“Our non-orthopaedic colleagues have become really very good at making very, very sick and unwell kids fit for surgery so that’s a cohort of patients that maybe in the past wouldn’t have been able to have surgery.”
Dr David Moore
Families waiting for these non-spinal ortho surgeries have previously told the Irish Sun that they feel “forgotten” – something Dr Moore wants to address.
He said: “I hope they don’t feel they are being forgotten because they are not.
“That is what most of us do. I operate on hip dysplasia. I lengthen legs. We all have lots of strings to our bow.
“They are not forgotten. They are just not getting the media prominence.”
SERIES OF SCANDALS
A series of issues have rocked the public confidence in Children’s Health Ireland over recent years including issues relating to unauthorised springs used in surgeries.
There are currently two separate reviews underway into the paediatric orthopaedic care – one by HIQA and one by a UK expert.
The Minister also ordered an audit of €19m that CHI was supposed to end the spinal waiting list issue.
On the €19m, Dr Moore said: “I had no hand, act, or part in the €19 million but my understanding is that every single penny was used in CHI.
FUNDING DIRECTION
“I think there were insinuations that it was mismanagement – it wasn’t in the slightest. I think maybe it just wasn’t all put into spine.
“But for instance one of the things, we now have ringfenced spine beds. There was a time when we didn’t.
“So we might have someone due to come in and then an emergency comes in through the emergency department and our bed gets filled and spine gets cancelled.
“So one of the things they did was build a medical assessment unit – the Starling unit – and that was where some of the funds went.”
‘VALID CONCERNS’
Dr Moore admits that they had a communication problem with parents that he says they are working to address with a new dedicated comms person.
Some advocacy groups believe a public inquiry into the failing of CHI for children waiting for spinal surgery should be held – something Dr Moore believes may not be necessary but says “I think people’s valid concerns need to be addressed and answered”.
Asked if CHI needs to rebuild the public’s confidence, Dr Moore said: “There has been a number of things in CHI over the past year and a half to two years that if I was a parent I would be suspicious.
“I’d be saying, ‘Wow what are those people doing.’ I think we’re working towards restoring confidence.
‘DOUBLE-EDGED SWORD’
“We haven’t restored it but we’re working towards it.”
Dr Moore points to the many negative stories about spinal service that have been in the media over the past year and says it has had an impact on staff who he says are working as hard as they can.
However, he adds: “By the way, perversely I think it’s great. Look at the resources we’ve got now.
“We now have the ability to do our jobs better. It is a double-edged sword from our point of view, so thank you in some respects.”
