The board of Children’s Health Ireland (CHI) and the Health Service Executive (HSE) spent years challenging “defiant” and influential staff at Ireland’s children’s hospitals before allegations of a toxic working culture came to light.
As former CHI board member Dr Gavin Lavery resigned from his role amid a number of controversies at the hospital group earlier this year, he warned Minister for Health Jennifer Carroll MacNeill that threats to safe care of children could not be resolved in the “current climate,” and the situation was unlikely to improve in the near future.
It comes as CHI told the Public Accounts Committee it believed the “unsubstantiated allegations” in a 2022 report did not meet the threshold of a criminal act.
The report, which CHI is refusing to publish for legal reasons, found a “negative and toxic” work culture and allegations of irregularities in the waiting list management system within the paediatric hospital group.
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The report, which led to a number of resignations from the CHI board, came after two other separate controversies within the organisation over the use of unapproved coil springs in spinal operations and questions about the threshold for hip operations.
Dr Gavin Lavery was one of four board members who resigned in May of this year. The departures of Dr Lavery, Brigid McManus, Catherine Guy and Mary Cryan followed the resignation of the board chair, Dr Jim Browne, in April.
In his resignation letter to Ms Carroll-MacNeill on May 27th, which was released under Freedom of Information, Dr Lavery said dealing with “challenging situations and behaviours” had been a part of his professional life for many decades.
Dr Lavery said, while the “vast majority” of those working in CHI go beyond expectations, the actions of “a small number” were questionable and “not in the interests of children”.
“These individuals are defiant and, when challenged by the Board and the Executive, have used their position to influence and distract – both inside and outside CHI. The ‘noise’ has made normal business impossible and has subsumed huge amounts of our energy and resources,” Dr Lavery said.
[ Children’s Health Ireland report referred to gardaíOpens in new window ]
He said the CHI board and the HSE “have been challenging the above for several years and have had some successes”, adding that they had always acted against any known “threat to the safety of children”.
“However, some of these issues are complex and arise from long standing behaviours. When such threats to safe care are called out, the solutions sometimes require time and space for the necessary processes to play out. The current climate does not allow that time and space, and the situation is not going to improve in the near future.”
In her resignation letter on the same day, Ms McManus said the CHI board had worked hard at “investigating and responding to difficult clinical issues that came to attention”. Ms Guy, in her resignation letter, told the Health Minister the CHI board “deserves the support of Government in its ongoing work and in dealing with further challenges to come”.
Ms Cryan’s resignation letter, sent on May 21st, was only one line: “I wish to advise you that I am bringing forward my retirement from the board of CHI, which is due in December 2025, to take effect immediately.”
And as he stepped down, Dr Browne described his time as chair as a “rewarding if challenging experience”.
Separately, CHI has sent a number of documents to the Dáil’s Public Accounts Committee following additional questions that TDs had for the hospital group. CHI chief executive Lucy Nugent shared legal advice that CHI had received which it said supported its decision not to publish the internal report. The legal advice was shared on the condition it was not circulated beyond PAC. Ms Nugent said it was “not in any way our intention to hide the truth, or hide behind legalities to avoid disclosure”.
PAC had also asked CHI if it had considered if the issues raised in the report had broken the law. The HSE has separately decided to refer the unpublished report to the gardaí.
“The unsubstantiated allegations in the report were investigated by CHI and they did not meet the threshold for criminality,” Ms Nugent said.
