My understanding is that the audit into unnecessary hip surgeries carried out on children at CHI hospitals is now complete. Can the Taoiseach confirm for the Dáil that this is the case? If so, can he tell us when that audit will be published? When I raised this scandal of unnecessary hip displasia surgery on children with him four weeks ago, he was unable to shed any light on the matter. He gave me no further information and he certainly gave me no answers. So, a month on, I ask him again, how many children are caught up in this emerging scandal? Are we talking about hundreds or is it more? How many letters have been issued by CHI to parents? What was the reference period for the audit? Is it years or is it decades?

Every single day, our offices receive communication from parents in distress. They are left asking themselves the gut-wrenching questions, was my child one of those operated on unnecessarily, and what are the consequences of this for my child?

In the case of one parent who has been in touch, their child was only three when they had surgery. This is the first parent to tell me that they have now received clinical confirmation that their child did not need the operation performed on them at a CHI hospital three years ago. This parent has now been told by a surgeon, having reviewed the scans from three years ago, that their child's hips were fine. The surgeon says that they would not have performed the surgery. We need to let this sink in - clinical confirmation that this child's surgery was not needed. This parent is absolutely devastated. She told me that she cannot believe what has happened. She describes it as like a horror film. She asks why her child was diagnosed with a condition they did not have and why her child was put through the trauma of surgery if it was not needed. She just keeps asking herself why.

Another of the mothers who reached out after she received the letter tells us that her son had his left hip operated on in 2018 but was told his right hip was fine. He was called back, however, in 2021 and told that the right hip did in fact require surgery, despite displaying no issues. She took the medical advice. She describes this as a devastating decision. She tells us her son's life deteriorated dramatically following this operation. He now suffers serious health development complications and catastrophic consequences from the surgery. The mother is overwhelmed thinking that her child's surgery might not have been needed at all. We have also received confirmation from a parent who received a letter whose child had the surgery in 2010. That is 15 years ago. The child is now a 20-year-old adult. Does this scandal, this issue, go back that far?

Tá scannal na leanaí a ndearnadh obráid gan ghá orthu ag fás gach lá. Tá soiléiriú agus freagraí ag teastáil anois. Cé mhéad leanbh atá i gceist? We have one parent who has clinical confirmation that their child's surgery was not required, and this scandal and stress are growing by the day. It should be remembered that the Taoiseach's former health Minister, Stephen Donnelly, knew about this a year ago and yet he delayed and parents are dealing with this only now. They can no longer be left in the dark. They need answers; they are entitled to that. I ask him again about the reference period of the audit, how many children are affected, whether the audit is complete and when it will be published.

Ar dtús báire, aontaím go bhfuil sé seo an-phráinneach agus gur ábhar buartha é. Is olc an scéal é an rud atá ráite ag an Teachta McDonald. Is é an príomhrud ná go mbeidh an audit cuimsitheach agus go mbeidh sé againn chomh luath agus is féidir. At the outset, this situation is extremely serious and has necessitated an external audit. That is the first point. For any child to go through surgery is in and of itself a trauma. For parents it is also a trauma. If it emerges that children went through surgery that was not required in the first instance, that will not only be very traumatic in itself but a scandal. It is important we await the completion of the audit and its presentation to the Minister. I spoke to the Minister yesterday. She has not received any final draft or the completion of the audit. I have spoken to the Minister and she made that point to me. That then makes it very difficult all around, in terms of commenting in a piecemeal way or on an individual case or a case-by-case basis. I am not in a position to do that until the full, comprehensive audit is finalised, presented to the Minister and the Government and obviously shared with this House, as it will be.

The Deputy is correct that CHI and Cappagh hospital have issued letters in recent weeks to families who may have concerns to provide information and so forth but, ultimately, it is the completion of the report that is key here. I understand there may have been drafts or whatever published, in The Ditch or elsewhere. I do not know. I cannot speak about the provenance of that other than to say the sensible thing for us to do is to enable Mr. Thomas and facilitate them to complete the report as quickly as possible given the anxiety and concerns that are undoubtedly out there. It is accepted those concerns will be there for families whose children will have gone through this particular surgery over a significant period of time.

I understand the audit process is in its final stages. Feedback on the draft report has been received, I understand, by the expert author and is being reviewed. We simply have to assemble all the facts on a comprehensive basis, await the outcomes of the clinical audit and then decide on actions resulting from the outcome of that. The entirety of what took place needs to be understood and laid out fully and transparently. We would then follow through on actions that would be necessary.

There are multidisciplinary teams in place in these hospitals in terms of pre-operative decision-making right across CHI and Cappagh hospital. That process commenced from March onwards. The hospital authorities are obviously taking on board the concerns and so on. It was raised initially via a protected disclosure in September 2023 relating to different thresholds for surgery being applied in CHI and the national orthopaedic hospital in Cappagh. The Department was notified in 2024. The clinical audit, as the Deputy knows, is being conducted by Mr. Simon Thomas, consultant surgeon to the staff of the children’s orthopaedic unit at Bristol Royal Hospital for Children. We simply have to await the completion of that.

Thank you, Taoiseach.

I hope it will be sooner rather than later to help deal with the concerns and anxieties, but also to deal with the issue itself.

Tá an scéal go léir scannalach gan dabht. Tá sé scannalach freisin go bhfuil tuismitheoirí agus páistí fágtha gan freagraí. This thing has dragged on and on. As I said to the Taoiseach, his Minister knew a year ago. Families then received these letters and there is an audit under way. Then there is this unbearable, almost cruel waiting and waiting. I have spoken to a parent who has told me they have clinical confirmation the child underwent surgery that was not needed. That is one. I do not know whether there are more.

The Taoiseach says we have to wait for the process be completed. My information is that the audit is in fact completed. The Taoiseach told me four weeks ago, by the way, that this was in "its final stages". That is not good enough. It is not good enough to issue letters on something of this magnitude that Government knew about for a year and more and leave families in that position. That is unacceptable. Can I ask him again about information he does know or should know?

Thank you, Deputy.

He should clarify, please, the reference period of the audit, how many letters have been issued and how many children are affected. When will we see the audit?

Hear, hear.

It is regrettable the Deputy would seek to politicise the issue, as she is attempting to do. The first people who should always be contacted in a situation like this are the families who are affected. That is why correspondence goes from the authorities - in this case, the hospital authorities, that is, CHI - to the families. That is as it should be. They should not be hearing about it in a piecemeal way or whatever because, first and foremost, they need full transparency.

And that is done.

Second, the Deputy must know in her heart it would be unacceptable to try to release piecemeal and case by case in this case. The sensible thing to do is wait. It is frustrating that people have to wait, but we have to wait for the full audit. I know the Deputy is well aware of all this, but it does not suit in terms of the politics of it.

Have you spoken to the parents who are waiting?

The bottom line is that a draft report gets sent to all who have been involved.

How many letters issued?

The feedback has come back.

How many letters?

The audit will have all of that information available for everybody.

Thank you, Taoiseach. The time is up.

Does the Taoiseach know how many letters were issued?

That is the proper way to do this.