Sinn Féin health spokesperson David Cullinane has raised concerns that the proposed inquiry into Children's Health Ireland (CHI) may not be broad enough to answer families' questions about the care of children with spina bifida and scoliosis. Cullinane, a TD, said his party will examine the Remy Farrell SC scoping report closely and be guided by affected families and advocacy groups.

The report recommends a statutory Commission of Investigation rather than the Tribunal of Inquiry sought by key advocacy groups. Cullinane said a Commission would have powers to compel witnesses and documents, but that does not address whether its scope is sufficiently wide to establish the full truth.

He said the Spina Bifida and Hydrocephalus Paediatric Advocacy Group and the Scoliosis Advocacy Network have made clear this is not the inquiry they sought, and their concerns must be taken seriously. A core problem, he said, is that the proposed scope appears too focused on the administration and management of waiting lists.

"Any inquiry needs to examine what happened to children, not simply what happened to waiting lists," Cullinane said. This should include whether prolonged waits caused conditions to deteriorate, whether delays changed treatment options, whether clinical needs became more complex, and whether delays contributed to poorer outcomes. It is not enough to establish how a waiting list was managed, he added.

Cullinane also said the proposed spinal surgery element may be too narrow and may not adequately examine the wider history of failures in scoliosis services. The proposed starting point of 1 January 2019 raises questions, he said, because in 2017 then-Minister for Health Simon Harris committed that no child with scoliosis should wait longer than four months for treatment by the end of that year. Serious problems existed well before 2019, he argued.

Campaign groups have highlighted concerns about children with spina bifida and scoliosis who were receiving care at Temple Street for many years before 2019. They pointed particularly to the period between 2009 and 2015, when they say Temple Street did not have a sitting urologist and internationally recommended standards of care were not met. There were also serious problems with scoliosis waiting lists and initiatives before 2019, Cullinane said.

If significant parts of that history are outside the scope, government needs to explain why and how an inquiry can fully establish what went wrong, he said. There must also be clarity about the circumstances of children who died while under CHI scoliosis services or following spinal surgery, particularly where there were serious complications or poor outcomes. No family should find their child outside the scope because of an arbitrary date or narrow terms of reference, he said.

Cullinane expressed concern that the proposed process appears focused on systemic issues rather than independently examining individual care pathways and the circumstances of individual children. Giving families an opportunity to tell their story is important, but it is not the same as investigating what happened to their child, why it happened, and whether failures in care contributed to the outcome. Government must explain what avenue will be available to families who want those individual answers, he said.

There are further concerns about delay, with significant elements dealing with spinal surgery and hip dysplasia apparently dependent on other investigations being completed. Families have already waited years for answers and need clear timelines and a process capable of delivering meaningful accountability, Cullinane said.

Cullinane also said he is concerned that Gillian Sherratt and Stephen Morrison, identified as family representatives, were not invited to a separate briefing held for advocacy groups. If families are genuinely to be at the centre of the process, there needs to be transparency around who was consulted, invited, and excluded, he said.

Sinn Féin will now engage directly with families and advocacy groups before reaching a final view on what the government is proposing. For Cullinane, the central question is whether this inquiry will examine the full experience of the children and what actually happened to them, or whether it will amount to a narrower examination of systems and waiting lists.