Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I collectively congratulate the Minister and Ministers of State on their appointments and wish them the best of luck. The Minister said in his opening statement:

I am pleased on more than one level to be here again. I have said on a number of occasions that our health service needs stability in its political leadership and direction.

One has political stability and direction in North Korea but it does not necessarily mean that it is going in the right direction. I hope we can bring the Minister back to the centre from time to time. I do wish him well on a personal level.

I must again raise the issue of scoliosis. Reference has been made to it in both opening statements. I accept that a lot of effort is being made but a lot more is being said than done in terms of the output. A target has been set of a maximum four-month waiting list for scoliosis paediatric orthopaedic surgery, but there is a problem with the target, namely, the delay in diagnosis in the first place. I have it on good authority that children are waiting an inordinate period for an MRI scan because they have to be anaesthetised to undergo the scan. I have been informed there are significant delays in accessing MRI scans. I would welcome an elaboration on that. It is fine to have a time limit on the waiting times for surgery, but if a child is waiting an inordinate time for the diagnosis in advance of the surgery, it is a problem that must be addressed meaningfully.

I met the family members of children suffering from scoliosis recently and I am aware the Minister met them as well. The group was from Kilkenny and was called the Scoliosis Advocacy Network. The women involved are very powerful and their testimony was very powerful in terms of the evidence they gave about the suffering and delays their children had to endure. I do not wish to turn this into an emotive issue. I raised it in the Dáil and the replies from the Minister were very positive. The sum of €1 million was potentially identified in the National Treatment Purchase Fund to address scoliosis. However, diagnosis and prognosis are critically important if we are to alleviate the suffering of children who are affected and to give them an equal opportunity.

Child and adolescent mental health services, CAMHS, were raised this morning in the Dáil on the Order of Business, but I raise it in the context of Cork. There is no point in us pretending the service is anything but chaotic. The service is almost negligible in the South/South West hospital group area. I have heard about very worrying cases recently, including children being held in inappropriate conditions in St. Stephen's Hospital in Cork. We are making very little progress with child and adolescent mental health services and we must put a strong emphasis on it. I accept there are difficulties with recruitment but that has been ongoing for a long time.

I thank Mr. O'Brien for his opening statement. I was interested by his statement that, "Ireland [is] now 19th across the countries studied, with an average rate of 4.64 per 100,000, which is now slightly lower than the European average". Will he provide reasons for that reduction? Is there a potential template for other cohorts of the population where we are not seeing as rapid a reduction? It would be useful if we could learn lessons from that. Is it due to the national strategy to reduce suicide or is it due to changes in circumstances in the economy? I would like to hear the reasons or if Mr. O'Brien could elaborate on that.

My views on the GP contract are well known to the Minister and Mr. Breslin. I still do not understand why half the GPs are outside the room looking in through an opaque window at the discussions that are ongoing for a new GP contract. The Minister said all stakeholders should engage in a proactive way, but half the GPs are outside the door. The key stakeholders are those who will deliver the service. I believe the National Association of GPs, NAGP, should be in the room as part of the discussions in a formal setting along with the IMO to ensure there is a clear understanding of what the contract will be and that it will not have to be discussed again by others outside the formal setting after it has been agreed in the formal talks. It defies logic and credibility to say that half the people who are expected to deliver the contract will not even be in the room discussing it. It is not just about the GPs, it is about the bedrock of all the strategies we are promoting, be that the Minister and his party, my party, Sinn Féin, the Labour Party and other parties, including as part of the Sláintecare report. We all support the move from hospital-centred care to a primary care and community care model. I still urge the Minister at this late stage to address the fact that half the GPs are not present at the talks. Cé mhéad nóiméad atá fágtha agam?