The questions raised by the independent audit of children's hip surgeries will take many months, perhaps even longer, to answer.
It will bring a period of great worry for parents and young children waiting to see if they are part of the patients where it was deemed surgery was not indicated.
The issue first emerged after concerns were raised with Children's Health Ireland by a whistleblower about the thresholds being applied when making the decision to undertake surgery for children with Developmental Hip Dysplasia (DHD).
Around 1,800 children and young adults will be offered a review and some of these are already under way. However, the process is expected to take around six months and will use external experts.
One of the major findings from the audit is that the percentages of pelvic osteotomies not reaching the criteria at Temple Street and Cappagh are so high that it mandates further inquiry.
The audit author, UK paediatric orthopaedic surgeon Mr Simon Thomas, also found that while there is worldwide variability between surgeons, the variance identified here cannot be accounted for by measurement error or observer variability alone.
Asked about this on RTÉ Radio today, Dr Colm Henry, the Chief Clinical Officer, said the surgeons believed the interventions were necessary and had evolved based on research.
Bernard Gloster, the HSE Chief Executive, described the variance as being of very serious concern and said measures will be taken to ensure this kind of variation cannot recur.
Minister for Health Jennifer Carroll MacNeill said she is moving now to strengthen governance and oversight structures at Children's Health Ireland and Cappagh.
She said this will be done with the appointment of two members of the HSE Board to the Board of CHI.
Lawyers representing some of the families said the report makes for difficult reading and that the percentage of affected children is very high.
They want speedy access to orthopaedic surgeon reviews and to establish what remedies are needed.
