CHI Review Reveals Recurring Delays in Pediatric Orthopaedics, Urology, Respiratory Care

A comprehensive review of governance and equity in patient access and waiting list management at Children's Health Ireland (CHI) has identified recurring treatment delays across several key specialties. These delays primarily affected orthopaedics, including spinal operations, as well as urology and respiratory medicine.

The delays impacted urgent, semi-urgent, and routine patients, stemming from a combination of excessive demand, limited capacity, complex cases, staffing constraints, and broader service pressures. While the review, published by the HSE, found no evidence of inequity in access between public and private patients, this conclusion was limited by data availability.

Commissioned by Minister for Health Jennifer Carroll MacNeill and conducted by the HSE Office of the Chief Internal Auditor, the review examined the period from January 2023 to May 2025, focusing on orthopaedics, urology, and respiratory medicine. The audit revealed frequent incompleteness or inconsistency in documentation related to waiting list management across these three specialties, including booking forms, referral letters, and supporting clinical records. Furthermore, clinical prioritization was not consistently recorded or clearly evidenced in source documentation.

Governance over National Treatment Purchase Fund and HSE-funded initiatives also lacked consistent evidence, with limited documentation detailing the preparation, review, approval, and monitoring processes. The audit also noted that the proposed future model for consultant private practice at the National Children's Hospital introduces governance, operational, and control considerations that require further definition and development.