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Irish Independent
02-07-2025
- Health
- Irish Independent
Ban on sunbeds is a ‘no-brainer', says Taoiseach
It comes as the Irish Cancer Society published its pre-budget submissions and warned that one person every three minutes in Ireland receives a cancer diagnosis. While the HSE issued a warning on the use of sunbeds on Monday, the number of skin cancer cases diagnosed in Ireland were 'rising rapidly'. The use of sunbeds by those under 18 was introduced in 2010 by then Health Minister Mary Harney and there have been numerous calls since for there to be an outright ban in Ireland. The HSE this week said there are 'lessons to be learnt' from Australia, where a ban on commercial sunbeds has been in place since 2016. Speaking in Tokyo, the Taoiseach said a ban on sunbeds would be something he would advocate for. "I would hope we would bring in legislation and I favour [a ban on sun beds],' Mr Martin said. 'It's something I would be advocating for. I'm of a view it is a no-brainer, anything that's a no-brainer we should do in terms of prevention,' he added. On the ongoing issue of the third level student contribution fees, Mr Martin again said the Government was committed to the gradual reduction over the lifetime of the Government. However, it remains unclear whether the process to reduce the fees will begin this year. 'In terms of the student contribution, everyone has agreed within Government that there wouldn't be special cost of living this year. So that has implications for all of the ministers starting positions in terms of the allocation that they currently have,' Mr Martin said. "So clearly, ministers have to get provision, not just in that area, but in some other areas as well, to bring it down. 'I would hope that would start in the estimates process that's currently being negotiated right now, and that we are committed to reducing it over the lifetime of the Government that's in the Programme for Government,' he added. Meanwhile, the Taoiseach said he believed the current level of cocaine use in Ireland was an 'epidemic'. It comes as €31 million worth of cocaine was seized off the coast of West Cork on Tuesday, with four men arrested in relation to the seizure. Asked if he believed cocaine use was an 'epidemic', Mr Martin said yes and added that its use was a worry for the health of the country. 'I believe it is. From what I hear anecdotally, the use and the prevalence of cocaine use has grown significantly and that is very worrying in terms of the health of the nation and younger people in particular,' he added. 'On the alcohol story, it's interesting, consumption has gone significantly down over the last 20 years, which is a positive from a public health perspective. But then there clearly is an increase in drug use, and we've had terrible tragedies, terrible, terrible tragedies with people as a result of using cocaine or other drugs also,' he added. However, he said it remains unclear if the reduction in alcohol consumption is linked with the increase use of cocaine. 'I think we need more scientific analysis of that. There could very well be. There could very well be a link between the two, and that would be very worrying,' Mr Martin said.
Irish Times
26-05-2025
- Health
- Irish Times
Hip surgery audit: How many more times will we hear ‘this can never happen again'?
'This is a damning report and it is clear from the findings that many lessons need to be learned and changes made to ensure that such events do not happen again in Irish hospitals ... consultants [should] work in teams with clear clinical leaders who will ensure that individual clinical practice is in line with best practice,' the Minister for Health said about the findings that unnecessary surgeries were performed on multiple vulnerable Irish patients. This statement was not – as you may think – made by Minister Jennifer Carroll MacNeill in the context of last Friday's audit report on surgeries carried out on children with developmental dysplasia of the hip (DDH) in Children's Health Ireland (CHI) hospitals at Temple Street and at Crumlin, both Dublin, and in the National Orthopaedic Hospital at Cappagh (NOHC), also Dublin. Rather, it was a statement made in March 2006 by Mary Harney, then minister for health regarding the shocking findings of Judge Maureen Harding Clark's inquiry report. That investigation into the scores of unnecessary hysterectomies carried out at Our Lady of Lourdes hospital in Drogheda, Co Louth, exposed a culture of deference to senior consultants, inadequate oversight and poor mechanisms for reporting and addressing potential medical malpractice. READ MORE The Dr Michael Neary scandal laid bare major weaknesses in the State's healthcare system as a whole, particularly in clinical oversight, transparency and accountability. Sweeping reforms followed this, and other controversies, including: the creation of the Health Information and Quality Authority (Hiqa) to set healthcare standards, monitor compliance, and ensure quality care; the restructuring of the Irish Medical Council ; the formation of the National Clinical Effectiveness Committee (NCEC) to oversee national clinical guidelines and audits; and the implementation of a national policy on open disclosure to encourage honest communication with patients following adverse events. At the core of reforms to strengthen patient care and safety was the introduction of a clinical directorate system in the HSE . This model embedded clinicians in leadership roles, giving them formal decision-making authority and, supposedly, creating clearer lines of accountability. [ 'A national scandal': Answers demanded after audit highlights over 100 unnecessary hip surgeries on children ] It represented a huge cultural shift: senior doctors were now expected to not only provide care, but take shared responsibility for the governance and quality of services. The aim of all these reforms, and others, was to build a safer, more accountable, and patient-focused healthcare system. Yet, more than 20 years later, we are again reading a report that demands questions about whether there were serious failings in clinical governance involving multiple patients. The proportion of pelvic osteotomies to treat developmental dysplasia of the hip in young children undertaken at CHI at Temple Street and Cappagh NOHC (among the audited sample cases between 2021-2023) was so high and out of line with international criteria that last week's audit report called for an extended review to go back to 2010. The report found that close to 70 per cent of surgeries did not meet the threshold for surgery , meaning they may not have been necessary. The report recommends that every case is offered a review. It also noted some medical records from cases it selected were missing and that an experimental surgical technique was used in some surgeries without proper informed consent. The HSE said it has already started to implement new safeguards as recommended by last week's review report, including cross-site preoperative multidisciplinary review meetings and the creation of an expert panel to establish standardised criteria for this type of surgery. But it has to be asked why weren't such safeguards already in place? Why was there no co-ordinated approach across the sites under CHI carrying out this surgery, given the body was created to merge the national children's hospitals before the move to the new national children's hospital? Why and how was this 'variation' in surgical practice allowed to continue for potentially so long (assuming the findings going back to 2010 will be similar to 2021-2023) and in so many patients? What happened between September 2023 when the protected disclosure was made, and last July when this audit was commissioned? Were concerns raised earlier by other staff? If so, at what level and how were they addressed? The pelvic osteotomy cases audited at Crumlin were found to be warranted and in line with international standards. Was this discrepancy noticed by anyone? Were no inter-site comparisons made? Was there no routine audit? Continuous review and audit of clinical practice, with a focus on improvement and applying the lessons learned, should be the cornerstone of any high-quality healthcare service. Audits can uncover unwarranted variation in clinical practice, which can lead to potentially avoidable poor patient outcomes. Yet in Ireland there remain serious gaps in how and where clinical audit is performed and an often touchy, secretive approach to disclosure and reporting. The concerns about children's pelvic osteotomy surgeries came to light not through standard audits or a report of poor outcomes, which is the basis for commissioning many healthcare reviews, but via protected disclosure by a whistleblower. Just like the Neary affair. As I wrote following the publication of the damning Hiqa governance review on the use of non-CE marked springs in surgery at CHI at Temple Street report last month, we have a complex and confusing web of governance and accountability in the Irish hospital system. When no one is clearly responsible, no one is truly accountable. We regularly hear about how essential robust clinical governance is to a healthcare system. But it's one thing putting protections and systems in place; it's another ensuring these actually work. Major failures are usually followed by reform, but reforms often fall short in practice and can be bogged down by confusion, resistance or fear. When changed structures are announced and new roles with increased responsibilities are created, filled and paid, who ensures these are actually functioning effectively, being supported adequately and those commitments are being fulfilled? Sometimes healthcare staff simply leave when they realise that nothing is being done to address alarming issues that are placing patients and staff themselves at unacceptable and potentially avoidable risk. Last week HSE chief executive Bernard Gloster spoke of how 'putting in place a mechanism to ensure this kind of variation can't recur is central to our next steps, and we will be working with everyone to ensure that this can't happen again'. Yet we must ask: how can we still be listening to promises that this can never happen again two decades after the Neary scandal? Priscilla Lynch is clinical editor of the Medical Independent and a freelance healthcare reporter who completed a fellowship in health innovation journalism with the International Centre for Journalists last year The DDH Parent Information Line is open for families who have queries following this audit's publication: Freephone 1800 807 050 (or 353 1 240 8706 from outside Ireland)
Irish Examiner
05-05-2025
- Politics
- Irish Examiner
Minister seeks to establish hangout spaces for teens with new recreation policy
The Government is to introduce a new national play and recreation policy for the first time in 20 years, with a focus on creating hangout spaces for teenagers. Children's minister Norma Foley has tasked officials in her department to lead on the establishment of the policy. Ireland has not had a national play policy developed in more than 20 years, with the previous policy, known as 'Ready Steady Play' being introduced in 2004 by then-children's minister Mary Harney. It is understood that the policy is being developed due to the changing play needs of children and adolescents, alongside the rising population. The most recent Census showed there are approximately 787,000 children aged between zero and 11, alongside around 500,000 teenagers between 12 and 18. In particular, the department is to consider social spaces available for teenagers, given their rising population alongside the lower number of facilities available. A recent review within the Department of Children found there is 'little recognition of the differing play and recreation needs of adolescent girls, who are even more underserved than adolescent boys.' It adds that it would be beneficial for local authorities to examine the recreational need of teenagers in greater depth as they require additional resources. The report also found that outdoor play 'improves children's physical health and wellbeing, their motor skills and co-ordination, resilience, cognitive functioning and social development, and promotes their creativity and imagination'. While the new development of the policy is ongoing, the Department of Children has highlighted that provision of play facilities has improved in recent years. In total, there are 960 playgrounds across all 31 local authorities. In comparison, 15 local councils did not provide any play facilities for children in 1999. Councils also provide 171 multi-use games areas – which are fenced off areas for games like football and basketball – alongside 59 skate parks. Ireland is one of only six countries to have a national play policy, alongside Northern Ireland, England, Scotland, Wales and Canada. While developing the policy, the Government will be required to engage and consult with children and young people. Under existing rules, it is obligatory for local authorities to engage with children and young people to receive grant funding to develop and upgrade playgrounds. A recent review within the Department of Children found there is 'little recognition of the differing play and recreation needs of adolescent girls, who are even more underserved than adolescent boys.' File picture In recent years, there have been calls for the Government to review its funding for playgrounds, with then-Senator Marie Sherlock highlighting the large difference between council allocations. Between 2017 and 2022, Clare County Council received just €30,034 under the Play and Recreation capital grant scheme, this compared to Laois which received €104,537, and South Dublin which was awarded €106,673. Cork City Council got €59,711 in the six years up to 2022 while Cork County Council was awarded €75,673 in funding. For 2025, the Government will make €500,000 available to local authorities for the development of new play facilities, as well as the refurbishment of existing facilities. Applications for the scheme opened in January, with requirements for play equipment to be child safe, and councils must prove that children and young people live in the vicinity of a proposed playground.
