Children's Health Ireland CEO Lucy Nugent has apologised to children and families impacted by recent revelations about CHI's culture, governance and practices.
In her opening statement to the Oireachtas Committee on Health, she said: "I am sorry on behalf of the management of Children's Health Ireland and I am sorry on behalf of the entire organisation.
"I am very aware that various issues that my organisation is grappling with ... have an enormously worrying impact on parents around the country, and whether they can place their trust in us."
Executives and senior clinicians from CHI appeared before the committee to update politicians on spinal surgeries, the recent hip surgery review and other governance issues at CHI.
Committee chair Padraig Rice began proceedings saying it was "somewhat disappointing" that the CHI report was not published before the meeting.
A summary of the report into governance and culture at CHI hospitals and the use of the National Treatment Purchase Fund was provided by CHI earlier this week.
Ms Nugent told the committee that she was determined to restore trust and faith in the national paediatric service.
She said that CHI wants the best outcome for children and when that does not happen, children are failed and trust is broken.
Ms Nugent said she was aware the impact of events over recent years have led to great pain being inflicted upon some of those who were in its care.
Sinn Féin's health spokesperson David Cullinane said he had never found it so difficult to prepare for a committee session since 2007, due to the full breadth of controversy at CHI.
He said: "It's frightening what was happening at CHI, and families feel very let down."
Fine Gael TD Brian Brennan said: "This could be one of the biggest medical malpractices in the history of the State."
"Let's call this out as it is," he said, and some of those attending voiced their agreement.
Independent Senator Tom Clonan said had he known about the contents of the unpublished report, he would not have consented for his son to have the surgery he underwent in 2018.
He said CHI was running "a three-ring circus," he said, with a "toxic, broken culture" and "abhorrent work practices".
"The 'rogue consultant' narrative that you are relying upon" is only an element of the problem, the senator said.
"You are the problem, and you must take collective responsibility for that."
Ms Nugent said that she accepts responsibility and that is why she has reconfigured clinical structures.
She said she is willing to conduct town hall meetings with parents where she would stand up and answer questions from them.
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'Unnecessary' surgeries
In recent months, members of the Opposition detailed what they called "unnecessary" hip surgeries from an unpublished report into practices at three CHI hospitals.
The review into Developmental Dysplasia of the Hip, or DDH, found that the majority of children who had pelvic osteotomy surgery at CHI Temple Street and the National Orthopaedic Hospital in Cappagh did not meet the threshold for surgery based on the criteria used for the audit.
Children who had surgery at Crumlin were found to have met the threshold.
Ms Nugent told the committee that the review of cases where developmental dysplasia of the hip were performed should have all children seen within six months.
She said the clinics are being arranged as quickly as possible and to date 105 appointments have been offered with 60 patients seen.
Ms Nugent said that for any child in the future listed for hip surgery, these cases are now discussed at multidisciplinary team meetings, so that all children that come to CHI for care receive the same standard and care across all its hospitals.
Executives at CHI updated the committee on progress in paediatric spinal surgery services.
At the start of June, 48 patients were waiting over four months for surgery, a decrease since the start of the year.
CHI said that 223 spinal procedures have been completed in the year to date, up on 196 such operations at the same point last year.
An additional Consultant Orthopaedic Spinal Surgeon is due to start in August, with recruitment under way for a further three consultant orthopaedic surgeons.
Figures provided by Children's Health Ireland show that of around 2,200 children who had a hip dysplasia operation since 2010, just 60 have been seen to date as part of a recently announced lookback programme.
CHI said that some families had to cancel their appointments for various reasons.
There have been 105 appointments offered to date, with 73 patients booked.
As a result of the hip dysplasia audit, which looked at 147 random cases, the reviews for children have been extended to any child who had this surgery since 2010.
When it was announced, health officials said the lookback could take around six months.