Letters to the Editor, June 10th: On clinical governance, alcohol tax and gardening leave
We were deeply concerned about whether the procedure was truly necessary and ultimately chose to decline it. We sought a second expert opinion who reviewed her medical records and imaging, confirming what we had feared: our daughter no longer had DDH and had never needed surgery in the first place.
We were lucky. Too many families were not.
The revelations about unnecessary hip surgeries are just one part of a far wider institutional collapse. From the use of non-medical grade spring devices in spinal surgeries, to the misappropriation of National Treatment Purchase Fund (NTPF) resources, what's becoming clear is that these failures are not isolated – they are systemic. Clinical governance, patient safety, and ethical standards were compromised across CHI. Children with complex needs were not treated with dignity or respect, but as burdens to be managed.
READ MORE
As a scientist, I am appalled. I cannot comprehend how invasive surgeries were conducted without solid clinical evidence, peer oversight, or proper audit.
This betrays the most basic principles of evidence-based medicine. As a parent, I am devastated. The very system meant to care for our children ignored parental concerns, dismissed expert warnings, and placed vulnerable lives at risk.
This crisis did not emerge in silence. Since 2017, advocacy groups – many led by parents – have raised alarms about systemic dysfunction within CHI.
Their warnings were persistent, informed, and largely ignored. Had they been taken seriously; my daughter would never have faced this decision – and countless other children might have been spared real harm.
We cannot accept vague apologies or bureaucratic delay. What is needed is a full public enquiry, criminal investigations where warranted and accountability at every level of CHI and the HSE, and binding reforms to ensure this never happens again. The lives and the futures of children depend on it.
Ireland's children deserve care that is safe, ethical, and humane. Nothing less. – Yours, etc,
DR THERESE MURPHY,
Lecturer in Molecular
Diagnostics and Bioinformatics,
School of Biological,
Health and Sports Science,
Technological University Dublin,
Dublin.
Alcohol consumption and tax
Sir, – The recent report showing a 4.5 per cent drop in alcohol consumption in Ireland last year (
'Alcohol consumption falls 4.5 per cent, putting Irish at European average,' June 9th
), is welcome news, reflecting healthier public attitudes and the success of evidence-based policy, including minimum unit pricing.
However, the suggestion from the Drinks Industry Group of Ireland (DIGI) that this progress should now justify a cut in alcohol excise duty is deeply misguided.
Alcohol continues to cause enormous harm in Irish society, with thousands of lives lost or devastated every year through liver and heart disease, dementia, breast cancer, domestic abuse and more.
Each year, alcohol costs the Irish State billions in healthcare, policing and lost productivity. Alcohol taxation remains one of the few public tools that reduces consumption while raising vital revenue to offset just a small fraction of the costs alcohol imposes on society.
If anything, our alcohol excise rates urgently need revision as despite rising costs and inflation, they have remained essentially unchanged since 2014.
Most Irish citizens do not know or understand the risks of alcohol consumption. The dangers of alcohol, particularly its links to cancer, cardiovascular disease and cognitive decline, remain hugely under-recognised.
The unambiguous position of the World Health Organisation needs to be better known: no level of alcohol consumption is safe for our health. – Yours, etc,
DR RALPH HURLEY O'DWYER,
Specialist Registrar
in Public Health Medicine,
Dublin.
Gaza and food aid
Sir, – I'm delighted by the international impact of the Madleen, due to the presence of Greta Thunberg and other international activists.
I wonder have your readers forgotten the 2010 Irish endeavour to respond to the tragedy of an earlier Palestinian Nakba.
Together with Malaysian support, we purchased a ship which carried 60 tonnes of cement for rebuilding essential humanitarian infrastructure in Gaza. And significantly, onboard was Mairead Maguire, winner of the Nobel Peace Prize.
The ship we named the Rachel Corrie after a young Jewish girl who gave her life in trying to stop the bulldozing of a Palestinian home.
As in the case of the Madleen, we were intercepted by Israeli forces in international waters. The Rachel Corrie was boarded from two Israeli gunships and we were taken into Ashdod. There were seven Irish and seven Malaysian activists onboard. Malaysia had assembled the funding for the purchase of the ship, which was fitted out in Dundalk, and where a retired Scottish captain was hired.
The then minister for foreign affairs, Micheál Martin, contacted me via satellite phone to express his concern for the safety of Irish nationals, and to inform me that he had been in touch with the Israelis. I explained that, in addition to delivering cement to Gaza, we intended to enter Gaza, just as our friends onboard the Madleen had intended.
In both cases, the attempt was to break the stranglehold over Gaza and the people of Gaza by Israel.
Micheál Martin understood the situation, and arranged for the Irish ambassador to meet me in Ashdod after our arrival at the detention centre.
At his request the ambassador met me, and together with his Thai counterpart, he agreed to get the Filipino crew, the Cuban engineer, and the Malaysian activists out of the Israeli prison as soon as possible.
These were all citizens of countries that did not recognise Israel. We Irish had agreed we would not leave detention until the other shipmates including the Scottish captain had been freed and flown home.
Our opportunity to prosecute Israel for military action in international waters was not taken up by Ireland or Malaysia, regrettably, and now we see the same violation of international law taking place. – Yours, etc,
DENIS J. HALLIDAY,
Former UN assistant secretary general (1994-98)
Ranelagh,
Dublin 6.
Sir, – In light of the Gaza genocide can we stop pretending there is such a thing as international law. Countries only talk about it when it is broken by another.
It is only enforced when it is opportunistic for wealthy powerful countries. Instant action occurs when container ships are threatened, but none when humanitarian aid is in international waters under a British flag. – Yours, etc,
JANE JACKSON ,
Greystones,
Co Wicklow.
Sir, – How ironic to see Israeli defence soldiers handing out food and water to protestors who themselves were trying to force Israel to hand out food and water to starving Gazans. – Yours, etc,
DAVID CURRAN,
Knocknacarra,
Galway.
Gardening leave and the HSE
Sir, – The two HSE employees who have been on gardening leave for 11 years must have very fine specimens by now. (
'Two staff on gardening leave for 11 years,'
June 9th).
In this other world 'gardening leave' is a term used to describe a short-term paid absence from work between two employments.
But in the public sphere it means being paid indefinitely (eleven years and counting) to do nothing.
Why would the gardener even contemplate the possibility of alternative employment in these circumstances?
Martin Wall reports the HSE as saying that it endeavours to carry out all investigations 'as expediently as possible'. I think 'expeditiously' may have been intended but 'expediently' fits the bill beautifully. – Yours, etc,
PAT O'BRIEN,
Rathmines,
Dublin 6.
Sir, – Two HSE staff on gardening leave for 11 years .
Clearly, they are creating something spectacular for Bloom. -– Yours, etc,
FRANK J BYRNE,
Glasnevin,
Dublin 9.
Sir , – I see that two HSE employees have been on 'gardening leave ' for 11 years.
With such experience perhaps a transfer to the Botanic Gardens would be in order. – Yours, etc,
HUGH PIERCE,
Co Kildare.
Some guides to St Stephen's Green
Sir, – Your interesting recent supplement on St Stephen's Green ('
A guide to who owns St Stephen's Green
', June 7th) reminded me how 21 years ago, when the shiny new Luas first pulled into Stephen's Green West, I suggested by letter to your paper that the four very functionally named thoroughfares surrounding the Green revert to their historical more attractively sounding monikers: ie. Stephens Green East – Monk's Walk, West – French Walk, South – Leesons Walk and North – Beaux Walk (as shown on Rocque's Map 1757).
All this time later 'You are now approaching French Walk' would still sound so much more sublime as you glide in on the Luas or stroll on to Beaux Walk towards the Shelbourne.
Ah let it be done, a little renaming enhancement to uplift further this famous old marshy Square! – Yours, etc,
HELEN KEHOE,
Stoneybatter,
Dublin 7.
Sir, – The headline 'A guide to who owns St Stephen's Green,' caught my attention. I was afraid the ownership of the public park had moved to the private sector and I'd be reading how the bandstand could now be rented for €3,000 per month.
So it was delightful to discover it only referred to the property around the rectangular Green. – Yours, etc,
DERMOT O'ROURKE,
Lucan,
Dublin.
Some pointers for the GAA
Sir, – I could not agree more with Nicky English's analysis of Saturdays Munster final in Limerick at 18.00hrs on a Saturday evening. ('
Weary Limerick's errors allowed Cork's confidence to flourish,'
June 9th).
I was one of the spectators who because I had to walk (my running days are over!) left the stadium at half time in extra time to catch the 21.00hrs train back to Dublin.
Let me declare an interest, I am a Corkman who loves the game of hurling and obviously delighted with the result. The performance by both sets of amateur players on Saturday was up there with the best I have been privileged to witness over the years.
I'll leave it to your columnists and others to describe the passion, excitement etc. of the game but would add some observations, which are meant to be constructive.
The core issue with the scheduling of games in both codes is the contraction of the season. It is an issue needing immediate attention to be sorted for the 2026 season.
There are so many reasons why it should, all of which have been well articulated, and I can honestly say I have yet to meet a supporter of either code who agrees with the short season for our inter county championships.
I fully agree with Nicky's comments on refereeing. I have been arguing for a long time that the game is too fast and hectic now for one referee and in my opinion we should have two, each in full control of their own half, at least for major championship games.
I also agree the new football rules in relation to the clock and hooter should be implemented as should some disciplinary measures on dissent and gamesmanship.
Not so sure about revaluing the goal to four points!
When I entered the Gaelic grounds at 17.40 hrs on Saturday and Croke Park at 15.30 hrs on Sunday there were no programmes for sale. Why? and please don't tell me they were all sold out!!
Another issue which I don't like bringing up is the toilet facilities at our stadiums. The scene under the Mick Mackey stand during the intervals on Saturday can only be described as appalling, disgraceful, third world.
Whatever about men jamming the entrances/ exits trying to get in and out , the sight of our women supporters, who are growing in such numbers, lining up in orderly lengthy queues is so so embarrassing and must be so demeaning for them.
I don't accept there is no solution to this problem in this age of mobile units which we see deployed in other venues throughout the country. – Yours etc.
JOE WALSH,
Sutton,
Dublin.
Gulf stream and climate change
Sir, – A recent letter from Richard Herriott (my first cousin as it happens) queried why the Environmental Protection Agency's (EPA)latest report did not mention the possible collapse of the Atlantic Meridional Overturning Circulation – more popularly known as the Gulf Stream. While the concern is valid, the omission is understandable.
The EPA's focus is on Ireland's emissions and our domestic climate action. The destabilisation of the Gulf Stream is indeed one of the most alarming global climate tipping points, but it is also largely beyond our direct influence.
In contrast, the report highlights the many areas where we can make a difference – reducing emissions from transport, agriculture, buildings, and energy.
These are spheres where policy and behavioural change can yield real and measurable results.
The real scandal is not what the report left out, but what we continue to leave undone. We are failing to act even where action is clearly within our grasp.
It would be tragic if, in the face of potential planetary upheaval, we chose to focus on the immovable rather than the urgent and fixable. Or we could do a Nero and pull out a fiddle. – Yours, etc,
JAMES CANDON,
Woluwe St. Pierre,
Brussels.
Season's Greetings
Sir, – At 9.20 am on Monday June 9th, an out-of-service bus passed me on Kevin Street, Dublin 8, bearing the greeting, 'Merry Christmas from Dublin Bus' on its display screen. Is this a record? – Yours, etc,
MARK HARKIN,
New Bride Street,
Dublin 8.
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Irish Times
17 hours ago
- Irish Times
How eating disorders are changing: ‘I'm not the stereotype. I'm a man, I'm plus-sized'
When William Dwyer Joyce was a teenager, skinny jeans and Indie bands were what was cool. To be slim was fashionable. As a someone who didn't fit into that stereotype, and who was always 'plus-sized', Dwyer Joyce turned to food as a coping mechanism. The now 32-year-old was diagnosed with binge-eating disorder when he was 21, though he says he struggled with mental health difficulties long before that diagnosis. 'For me, my binge eating was very secretive. It was going to the shop, getting large amounts of things like chocolate, crisps, cookies, whatever. And going home and secretly eating it to the point where I could not eat it any more,' he says. 'It created a coping mechanism that was quite harmful because my body image was very poor. It was about numbing. In a sense it was self-harm. If you eat to the point of pain, it's not a nice thing to go through.' READ MORE Compounding this difficulty, Dwyer Joyce also struggled with alcohol addiction and drug misuse issues. These challenges, he says, all came from the same place: a desire to be able to exert control. He is now five years sober. 'When I got sober, it was like I was in a house that was on fire. Sobriety put the fire out, but now I'm standing in rubble and I have to build the house again,' he was when he seriously sought help for his eating disorder. 'In April 2020 I got sober for the last time. A year after that, in 2021, I had a year of sobriety under my belt. My 30s were knocking on my door and I thought, I cannot live like this forever and the only person who can change this was me.' One difficulty he found when seeking help, he says, was the questioning attitude and scepticism he faced by some healthcare professionals because he doesn't fit the common eating-disorder stereotype: a young woman or teenager with anorexia. 'I am the opposite of the stereotype in that I'm a man, I'm plus-sized, I wasn't restricting food,' he adds. 'There is all this messaging around fatness or plus-sized people that if you're fat it's a moral failing or you're lazy or you don't care about how you look. But that's just not true.' William Dwyer Joyce: 'I am the opposite of the stereotype.' Photograph: Dara Mac Dónaill This stereotype is beginning to change, according to Laura Casey, director of services at Lois Bridges, an eating disorder treatment centre in Sutton, north Co Dublin. The number of young men seeking help at the centre has increased in recent years, she notes. Casey attributes this rise to the increasing gym culture seen online – in which men are constantly fed images of bodybuilders with very little body fat – combined with the masculine tendency of men to keep their feelings to themselves. 'But when they do go and reach out, they're not heard the same. Their voices can be dismissed a bit easier,' she says. Another changing trend is the prevalence of a condition known as avoidant/restrictive food intake disorder, or Arfid, which is often diagnosed among people who are neurodivergent. 'It's sometimes called the beige diet; they eat a lot of chicken nuggets and chips. But we're moving away now from language that describes these people as being a picky eater, and acknowledging in many cases they have a sensory aversion to something.' Laura Casey, director of services at Lois Bridges eating disorder treatment centre in Sutton, Dublin. Photograph: Dara Mac Dónaill According to Casey, Arfid can have a significant impact on an individual, particularly in a social setting. 'Sometimes a person's diet is so restrictive they won't eat. There is a lot of shame and stigma if all they are able to eat is a chicken fillet roll. So, nutritionally, they can be at the same risk as anorexia. It affects their vitamin intake and electrolytes,' she says. When it comes to certain foods, some people with this diagnosiscan have a panic attack or feel like they're choking. 'They can only eat yoghurts and drinks,' she adds. Awareness of eating disorders has increased since the Covid-19 pandemic, when there was a rise in the number of referrals for treatment to HSE eating-disorder teams, who provide specialist treatment. HSE data shows there were 894 referrals to such teams last year, a 33 per cent increase on 2023. There was also a 24 per cent rise in accepted referrals, where patients proceed to treatment after an initial consultation. A total of 562 patients were assessed last year, of which 90 per cent were female and 59 per cent were children under the age of 18. One-third were teenagers aged between 15 and 17. Still, the service also saw the number of adults accessing treatment increase by 51 per cent. You're either too sick for the psychiatric hospitals or you go into a general hospital and there's no help there for these things — 'Rebecca' Of those assessed, 503 had an eating disorder, 118 more diagnoses than in 2023. Some 63 per cent (318) presented with anorexia nervosa; 18 per cent (97) with an 'other specified feeding or eating disorder' (OSFED); 8 per cent (42) with bulimia nervosa; 3 per cent (16) with Arfid; and 2 per cent (10) with binge-eating disorder. Many eating disorders begin the teenage years. But disorders often don't end there. Rebecca, not her real name, was first brought to Child and Adolescent Mental Health Services ( Camhs ) at age 15. However, she believes this 'did a lot more harm than good'. Although she acknowledges there are many good people working in the service, she was unhappy with the attitudes she faced in relation to her anorexia. Then the coronavirus lockdown happened, shutting down vast swathes of regular life. 'Everything was gone, and I deteriorated very rapidly.' Following this, she underwent a 'string of hospital admissions and A&E presentations' to help with her diagnosis, but she says it was like a 'revolving door'. 'You're either too sick for the psychiatric hospitals or you go into a general hospital and there's no help there for these things. You're stuck between nothing that will help,' she says. 'When you go into a general hospital, it's really only for one thing: to be fed against your will. But it's so important to get to the root cause of it. It was very difficult to find help that suited me. And then when people do offer you that help, it's hard to accept it if you've had bad experiences. I'm still struggling a lot.' The almost 21-year-old makes a comparison to alcoholism: relapse can be a common challenge for people, and oftentimes the difficulties of the illness are persistent. 'But there's no AA meetings [for eating disorders] around the country that you can pop into. You're kind of just left alone,' she adds. Dr Art Malone, a consultant psychiatrist and chair of the eating disorder specialist interest group at the College of Psychiatrists, says one of the biggest challenges is that some areas of the State have inadequate access to the necessary specialist services. 'Not all areas that have a specialist service are fully resourced to deliver the sort of service they would need to do. The biggest one is probably the lack of higher-level care needed for severe cases, so the lack of inpatient treatment is something all teams have to contend with,' he says. Dr Malone says that for the 'very small minority of patients' who have very severe, acute illnesses there is 'no higher-level care available in the way that it should be'. 'What ends up happening is there can be funding sought in other places such as private places or abroad but there can often be fairly lengthy delays in arranging that and then even when it is arranged – because it's taking people out of their home environment – it can be quite tricky then to transfer their treatment back to their own home set-up,' he says. 'Body positivity was such a thing, but now we've gone back almost 20 years,' says Alicia Woods, clinical nurse specialist at Lois Bridges. Photograph: iStock Dr Malone says there's a big push to try to make early intervention a priority, as this can prevent people from needing inpatient care. He cites international research that found the relapse rate for people with severe illness who receive inpatient treatment is around 50 per cent in their first year. 'But it's important to note that services where they do exist are extremely hardworking. Things have come on such a huge distance in a very short time, but it's coming from such a low base in terms of service accessibility that there is still a way to go.' [ Eating disorders: 'I wouldn't speak to my worst enemy the way I talked to myself' Opens in new window ] In recent years, the Government has taken steps to improve eating-disorder services. Currently, 14 of the 16 specialist eating disorder teams recommended in its internal plans are funded. Minister of State for Mental Health Mary Butler says no patients have been treated abroad this year so far for specialist eating-disorder care. 'I'm very proud of the progress we are making in establishing a full suite of services to support people with eating disorders, from early intervention in the community to the development of specialist inpatient beds for acute care,' she says. However, things are far from perfect, those working in the sector say. Figures from the HSE show that one-third of funded posts at eating disorder regional specialists teams are currently unfilled. In the adult eating disorder team in the Sligo, Leitrim, South Donegal health area, there are more vacancies than people in post: 3.2 whole-time equivalent staff are in place, with seven unfilled posts in the area. Furthermore, there are only three adult specialist eating disorder beds in the country, all of which are in St Vincent's hospital, Dublin. The rules for these beds, which are for those who are acutely unwell, require patients to be within that hospital's catchment area to be treated there. As a result, people with eating disorders outside that area who go into public hospitals for treatment are typically referred to a general psychiatric unit. Often they are unable to access specialised care in such settings. However, The Irish Times understands a plan has been devised by the HSE to increase the number of public eating-disorder beds nationally. Minister of State for Mental Health Mary Butler says no patients have been treated abroad this year so far for specialist eating-disorder care. Photograph: Brian Lawless/PA Wire At least 20 new specialist beds will be established in the coming years, under proposals submitted by the HSE for Ms Butler's approval. The beds will be spread between Dublin and the rest of the country, but all of them will have a national catchment area. For some people, recovery feels impossible. Aoife, which is not her real name, developed eating disorder behaviours when she was 12, after she sought to lose weight for her Confirmation. 'My family weren't very nice about my body. But also society. You'd be in drama class and I was the biggest so I would have to try on the costume and if it didn't fit me then nobody would get it. Then there were things like the Special K diet, or Kate Moss's saying about skinny being better,' she says. The 32-year-old Cork woman says she was diagnosed with anorexia at the age of 15, and went into hospital when she was 16, which she describes as 'the worst point in my life ever'. 'I couldn't control anything. I had a tube in my nose, I wasn't allowed to walk anywhere. I basically just lay in bed. I soiled myself because it would expend too much energy to go to the bathroom. It was only about weight restoration, not about treating the eating disorder,' she says. She struggled through college but was determined to continue her studies. I've been told I'll never recover. I have chronic anorexia. So you ask yourself, what's the point in trying? — 'Aoife' After graduating as a teacher, she realised she needed to get better before she could work full-time. In 2016, she returned to inpatient care. She improved somewhat, she says, but was not in recovery. She was admitted again two years ago, but had to leave early due to panic attacks. For her, she says, a history of trauma is playing a role in her current condition: her sister died when she was very young. 'I overate when she died; that was soothing myself. My life felt out of control, I didn't know who would die next. Food was something I could control,' she says. But it is 20 years since the onset of those challenges. These days, she feels quite hopeless about her current trajectory. 'I've been told I'll never recover. I have chronic anorexia. So you ask yourself, what's the point in trying? Normal eating is no longer normal for me. This has become my normal and it's very hard to see outside of it,' she says. [ Eating disorders in later life: Some of my peers have had teenage weight levels for decades Opens in new window ] 'It's pointless to be here every day. I keep wondering, how did things come to this? I'd love for someone to tell me what to do because I just don't know where to go or what to do. I look inward wondering what I could do differently. What did I do to deserve this?' Trying to find somewhere to go is something many patients experience. Alicia Woods, clinical nurse specialist at Lois Bridges, says the centre is a private facility, but they receive 'phone calls everyday of the week from people who don't have private health insurance'. 'We treat a range of eating disorders. And in terms of age, we've treated from 18 up to people in their early 70s,' she says. 'The majority of older people with eating disorders have had it their whole life but they just haven't had the information, education or support to seek help. Some people do develop it later in life.' Though Woods says the reasons why individuals develop eating disorders are complex and nuanced, she believes social media is playing a role. 'Body positivity was such a thing, but now we've gone back almost 20 years. The videos on social media, encouraging people to obsessively run 5K a day, or the 'what I eat in a day' videos [and the food quantity] is not enough to feed a toddler,' she says. She is also concerned about the potential impact the widespread availability of weight loss jabs like Ozempic might have on vulnerable individuals. 'We know that people can put in fake weights and get these prescriptions. If someone already has a low [body mass index] ... the potential of that is frightening,' she adds. But even when people can access treatment, often recovery is not linear, according to 38-year-old Edel Higgins. She was diagnosed with an eating disorder when she was around 25. She didn't know much about such disorders at the time, but says she had 'always tried to change my physical appearance'. [ Families: the untapped superpower in eating disorder recovery Opens in new window ] It took four inpatient stays before she reached a point where she sees herself as being in recovery. She says: 'It doesn't just take one go. People often feel guilty when they have to go back. But it's such a complex illness.' The Tallaght woman is four years in 'proper recovery', but she says for her that doesn't mean the eating disorder is 'completely gone', but just now she has the 'resilience' to acknowledge and challenge those urges when they arise. She writes poetry to help her cope. She looks at inspirational quotes hung up on her wall. 'Sometimes I wish I could wake up, go about the day, not having all of these overwhelming feelings – the eating disorder and mental health [difficulties]. But it doesn't work that way. It can be frustrating. But it's about findings ways to deal with it.' Bodywhys (The Eating Disorders Association of Ireland) – – (01) 210 7906 – alex@
The Journal
a day ago
- The Journal
Charlie Bird's wife supporting All-Ireland morning walk in aid of Motor Neurone Disease
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Irish Times
a day ago
- Irish Times
Boy who suffered catastrophic injuries after fall at park settles case with €3.3m interim payment
A boy who suffered 'catastrophic and life-changing' injuries after he fell and hit his head at a Dublin City Council-owned park almost 10 years ago has settled a High Court action against the local authority and a GP with an interim payment of €3.3 million. James Higgins, who is now 12, from East Wall, Dublin 3, requires around-the-clock care, is essentially non-verbal, suffers with epilepsy and will be a wheelchair user for life, the court heard on Friday. The interim settlement agreement was reached following mediation. The case will return to court in six years. The court heard there were complex questions relating to causation and liability in the case. The case had been contested. READ MORE Kevin Higgins brought proceedings on behalf of his son James against Dublin City Council and Dr John Taylor, claiming they acted negligently and in breach of their duties. Jeremy Maher SC, for James, said the boy, when he was two-and-a-half years old, suffered 'catastrophic and life-changing' arising from a fall at May Park, Malahide Road, Dublin 5, on December 1st, 2015. Mr Maher said the boy, while retrieving a football, fell on an all-weather soccer pitch where slush had accumulated and hit the left side of his head. Mr Maher said it was their case the pitch was in dangerous condition and should not have been in use and that the council was in breach of its duty and negligent in its management of the park. James was subsequently brought to Dr Taylor's surgery at Ardlea Road, Artane, Dublin 5, Mr Maher said, where it is alleged the GP was negligent and breached his duty in failing to immediately refer the child to hospital. James was later that evening brought to Children's Health Ireland Temple Street. There it was determined he had suffered a bleed within his skull and he underwent emergency surgery, Mr Maher said. Mr Maher said this surgery was life-saving, but the damage had advanced to such an extent that James was left with devastating injuries. The barrister said James required around-the-clock care, was essentially non-verbal, suffered with epilepsy and would never be able to work or live independently. Mr Maher said James's 'heroic' parents had given up their careers to care for James. Mr Maher said that following mediation, the defendants had agreed the interim settlement of €3.3 million. Mr Justice Paul Coffey approved the settlement, stating that James's case was a reminder of the fragility of life and the limitless nature of parental love. He said it had been 'deeply humbling' to listen to Mr Higgins address the court about James's condition and their experience of his care.
