The Irish Times view on the end of Children’s Health Ireland: promise unfulfilled

Children’s Heath Ireland (CHI) was established in 2018 by the then minister for health and now Tánaiste Simon Harris with the laudable objective of trying to coordinate and improve paediatric services throughout the State. It pulled together under one body the four children’s hospitals in Dublin along with paediatric services across the country. It was also charged with governing and managing the new Children’s Hospital in Dublin, which will replace the existing hospitals and is scheduled to start treating patients next summer.

The current Minister for Health, Jennifer Carroll MacNeill, confirmed this month that CHI will now be folded back into the HSE. Carroll MacNeill cited the impending completion of the new children’s hospital and the changing healthcare environment as the reason for the policy reversal.

Both of these reasons are valid, but it is hard not to link her decision to the chequered performance of CHI over the last eight years, which culminated in a damning report from the Health Information and Quality Authority (Hiqa) earlier this year. The report into the use of non-surgical springs in scoliosis surgery painted a picture of an organisation with poorly implemented controls and unclear reporting lines. CHI did not deliver on its promise.

The amalgamation of CHI back into the HSE is a complex task and not expected to be complete until 2027. As yet, there is no road map as to how it will happen. The process is complicated by the fact that the HSE is itself restructuring, with the establishment of six health regions which will replace the existing hospital groups and community health organisations.

Where the various paediatric services around the country and the new children’s hospital – with its national mandate – will sit within this structure has not been disclosed. What is clear is that the interregnum will straddle what is probably the single biggest challenge of Carroll MacNeill’s relatively short political career: the successful opening of the new hospital, which is years late and billions over budget.

The Minister has demonstrated a penchant for getting her hands dirty, which has already led to one well-publicised spat with the chairman of the Mater Hospital over the extent of her remit. Either by accident of design, she – and her officials – are now in a position to exercise maximum influence over the opening of the new hospital, should they wish.

It is something of poisoned chalice, given the inevitable teething problems and potential for last minute snags, but on balance they may prefer to be the masters of their own fate. Political expediency may rule the day but whatever structure replaces CHI, clear and robust lines of accountability are needed or else the failures of the past are likely to be repeated.