Children's Health Ireland Spinal Surgery Review Still Incomplete Three Years After Concerns Were First Raised
A review into spinal surgery concerns at Children's Health Ireland remains incomplete three years after it was initiated in September 2023, with the second phase of the investigation — which examines governance and capacity — not expected to conclude until the end of 2026. The review, which has been widened to cover surgeries performed by a specific consultant between 2016 and 2023, has seen 62 families contacted for clinical follow-up, while the report from the first phase remains unpublished due to ongoing legal issues.
Background
Children's Health Ireland is the organisation responsible for delivering paediatric health services across Ireland, operating from Temple Street and Crumlin hospitals in Dublin and from Connolly Hospital in Blanchardstown. It is in the process of transitioning to a new national children's hospital, which has been under construction at the St James's Hospital campus in Dublin and has been the subject of significant controversy over cost overruns and delays.
The spinal surgery review was initiated in September 2023 following concerns about the practice of a specific consultant at CHI Temple Street and the National Orthopaedic Hospital Cappagh. The consultant, who has been on leave for several years, performed paediatric orthopaedic procedures including spinal surgery, limb reconstruction, and surgical dislocation of the hip. The concerns that triggered the review related to the outcomes of some of these procedures and the adequacy of the clinical governance arrangements surrounding them.
The review was initially expected to take approximately one year to complete. Three years on, it remains unfinished — a delay that has caused significant distress to the families of children who were treated by the consultant and who are waiting to understand whether their child's care was appropriate and whether any follow-up action is required.
Key Developments
Following the completion of the first phase of the review, the HSE announced in February 2026 that the scope of the investigation would be widened. The expanded look-back covers surgeries performed by the consultant between 2016 and 2023, focusing specifically on spinal, limb reconstruction, and surgical dislocation of the hip procedures. The HSE emphasised that the widening of the scope was a precautionary measure rather than an admission of harm, but the decision to contact 62 families out of 91 reviewed cases for clinical follow-up has understandably caused anxiety among those affected.
The report from the first phase of the review has not been published due to ongoing legal issues — a situation that has frustrated families who are seeking transparency about what the review found and what actions are being taken as a result. The second phase, which examines governance and capacity within CHI's orthopaedic and spinal surgery services, is not expected to be completed until the end of 2026.
A separate audit of governance, equity in patient access, and waiting list management at CHI, published in June 2026, identified persistent delays in spinal operations and other treatments, attributed to high demand, limited capacity, and staffing constraints. The audit also found that waiting list management records were frequently inconsistent or incomplete, with clinical prioritisation often lacking clear documentation. CHI developed a 32-point action plan in response, with 20 actions reported as fully or partially complete by June 2026.
Why It Matters
The CHI spinal surgery review matters because it involves some of the most vulnerable patients in the healthcare system — children who underwent complex surgical procedures and whose families trusted that those procedures were being performed to the highest standards. The three-year delay in completing the review is a source of genuine distress for the families involved, who are living with uncertainty about whether their child's care was appropriate and whether any long-term consequences may emerge. The broader governance issues identified by the June 2026 audit — inconsistent waiting list management, inadequate documentation of clinical prioritisation — suggest that the problems at CHI are not confined to the specific consultant under review but reflect systemic weaknesses in the organisation's management of its orthopaedic and spinal surgery services.
Local Impact
The families affected by the CHI spinal surgery review are drawn from across Ireland, as CHI Temple Street and Crumlin are national referral centres for paediatric orthopaedic and spinal surgery. The impact of the review on these families has been significant: the uncertainty about whether their child's surgery was appropriate, the anxiety of waiting for clinical follow-up appointments, and the frustration of not being able to access the first-phase report due to legal restrictions have all taken a toll. CHI has established a dedicated Spinal Surgery Management Unit to oversee service improvements and manage patient pathways, and the unit has reported improvements in waiting times for outpatient appointments — from an average of 6.8 months in August 2025 to 3.4 months in August 2026. However, 93 patients remain on the active wait list for spinal surgery, and the broader governance issues identified in the June audit have yet to be fully resolved.
What's Next
The second phase of the CHI spinal surgery review is expected to be completed by the end of 2026, with the report published as soon as the legal issues surrounding the first-phase report are resolved. CHI has indicated that it will publish both reports simultaneously when the legal constraints are lifted, to provide families with a comprehensive account of the review's findings and the actions being taken in response. The 32-point action plan developed in response to the June 2026 audit is being monitored on a quarterly basis, with the remaining 12 actions expected to be completed by the end of the year. The new national children's hospital, when it opens, is expected to provide significantly improved facilities for paediatric orthopaedic and spinal surgery, with dedicated operating theatres and recovery facilities designed specifically for children.
