Questions over the length of time some children are expected to wait for much-needed healthcare are not new. Families have long raised concerns about a deterioration in their children’s condition as they languish on a waiting list awaiting much-needed intervention.The Health Service Executive internal audit and narrative report, both published on Monday, show, however, that those long-waiters are not the outlier but often the majority.The audit, conducted by consultants EY, looked at three specialities: orthopaedic (including spinal); urology; and respiratory medicine – from January 2023 to May 2025. Its objective was to examine the governance and equity in patient access and waiting-list management in the children’s hospitals’ provider. It found patients experienced delays beyond recommended time frames, driven primarily by capacity and workforce pressures. For spinal patients, only 41 per cent (nine out of 22) were treated within the clinical, recommended time frames (CRTs) – medically advised maximum waiting time for a patient to be seen by a specialist or undergo a procedure – meaning 59 per cent faced delays, sometimes for several months.Delays happened for urgent and less urgent cases, with delays beyond the CRTs ranging from 14 to 699 days, with a median delay of 143 days. In urology, 41 per cent of the 73 reviewed patients were treated outside the CRT, with the median delay being 152 days.The most significant delay was observed in a “non-urgent” case in which a patient was placed on a waiting list in 2017, but did not undergo treatment until 2024.Though the internal audit did not find any evidence of preferential treatment of patients in the private system versus the public system, there were notable differences in some areas.One unnamed orthopaedic and spinal consultant had a waiting time for public patients of 8.7 months in July 2024, while for private patients that month – of which there were fewer – the average waiting time was two months. Across all specialities in the hospital group, the narrative review found that as of October 2025, 73 per cent of children on Children Health Ireland outpatient and 67 per cent of children on Children Health Ireland inpatient lists with urgent referrals did not receive appointments within the CRT of less than 28 days.The purpose of these maximum waiting times is to “minimise risk and/or achieve best clinical outcomes”. Yet between two-thirds and almost three-quarters of patients are not being seen within that time frame. For many senior health officials, the audit is likely to provide some solace that there is no evidence to suggest inequity between public and private patients, following serious allegations about this practice.For families, however, it serves only to confirm what they have said for many years: children’s healthcare is often delivered far too late, and until that is resolved, the chasm of distrust is only going to grow.