A national screening programme to help babies with hip dysplasia avoid surgery remains unimplemented, eight years after its recommendation.
The HSE disbanded the steering group that made the recommendations this year, without implementing any of them.
Up to 100 children per year require invasive hip surgery due to late diagnosis, according to estimates.
In 2017, a steering group advocated for a national screening programme to prevent unnecessary surgeries.
Hiqa, the health watchdog, expressed concern last year about the lack of action on this recommendation.
The watchdog stated: “Current practice is, therefore, not supported by the governance, end-to-end care, quality assurance, and monitoring of outcomes that would be associated with such a programme.”
They found evidence of potential “variation in the implementation” of screening practices between hospitals, even within the limited approach currently used.
One consultant highlighted that early detection of hip dysplasia could eliminate the need for surgery. The consultant explained:
“Problems arise when the diagnosis is made late. The sooner you spot it, you can treat it in a harness or a brace. And the children respond very well and have excellent results.”
However, the consultant emphasized the lack of a national register:
The consultant versed in hip dysplasia care, asserted: “The whole point about DDH [hip dysplasia] is if you treat it in time, it can nearly all be done non-operatively.”
Recent weeks have seen public outrage regarding the high number of surgeries, including allegedly unnecessary ones, at CHI at Temple St and the National Orthopaedic Hospital, Cappagh.
The consultant commented: “In the recent CHI report, if you subtract the unnecessary operations from the overall number, you are left with a lot of necessary operations. In many cases, it is likely that they were necessary because of late diagnosis.”
Concerns are rising within health circles about the potential impact of the CHI crisis on efforts to address existing gaps in care.
“The whole thing is in chaos now. It’s probably seen as toxic. There is no sense of urgency, no sense of determination to get this done,” the consultant cautioned.
Sinn Féin health spokesman David Cullinane stated that in addition to the lack of implementation of recommendations, “no national database or audit was ever put in place”.
“It is worrying that these recommendations were not implemented and this has caused understandable concern for those involved in this valuable work.”
The HSE stated that health regions are now responsible for screening.
The Department of Health cited communication from the NSAC last month to doctor’s groups who raised concerns, suggesting the best approach “would likely be the systematic application of the current selective screening programme”.
