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Ireland 25 years behind on standards

Ireland has fallen 20-to-25 years behind what is accepted as international norms in paediatric interventional radiology services.

Dr John Donnellan

Dr John Donnellan

This stark pronouncement was made by Dr John Donnellan, Paediatric Radiology Fellow at Temple Street Children’s University Hospital, at the IMO AGM, when he revealed that there were no paediatric interventional radiologists currently employed by the HSE.

“In Ireland, if a child is diagnosed with a solid organ tumour, in order to get that diagnosis they undergo a general anaesthetic and open biopsy. If you are an adult, you would have a local anaesthetic through the skin, and a percutaneous image guided biopsy — with a shorter length of hospital stay and less complications,” explained the NCHD Committee member.

“These children are often in the first few weeks of life, so having any form of operation has the potential of being disfiguring and complicating,” he noted.

Dr Donnellan added that if an adult went into hospital and required intravenous access for more than three days, they would have open access PICCs, Port-a-Caths, or dialysis catheters — all of which were given under image guidance.

“If you are a child you end up going to theatre, having another general anaesthetic and an open venotomy and surgical dissection down to the vein to place the catheter. This is sub-standard practice in adults, but it is the standard of care we are offering our children,” he commented.

There are currently 58 adult interventional radiologists practising in Ireland — roughly one for every 60,000 of the population. “There are zero funded interventional radiologists for children — zero! This standard of care is not acceptable,” he implored.

Members passed two motions on the topic calling on the HSE to urgently develop a paediatric interventional radiology service, and for the Executive and Departments of Health and Public Expenditure and Reform to stop subjecting children to substandard levels of care with outdated open surgical procedures where minimally invasive alternatives existed.

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