Mr. Connor Green:

I thank the Chair. What I will say every time I answer a question about scoliosis is that I want to remind everyone that scoliosis is not the major challenge here. I really want the members to understand that when we leave today.

In relation to scoliosis, idiopathic is a group we do not have a cause for. We call it idiopathic because as doctors we like to sound smart and do not like to say we do not know. The Chair spoke about the time to access the care and about it being diagnosed in the womb. You have the group of children who will be diagnosed early in life who have no other medical problems. That is the idiopathic group. If we leave them untreated, they can potentially not have a big enough lung capacity to survive beyond their 20th year. In fact, most of the work done in that originally was in Ireland. We need to consider that scoliosis is just a symptom; it is not a diagnosis.

The most important thing, and I say it to all families when I meet them, is that the first thing we have to do is to decide what has caused their scoliosis. That means you need access to a physician and also some advanced imaging. If you are a child born with scoliosis, in theory we should get at that group quite quickly because there are very few of them. Early-onset idiopathic scoliosis is a really rare diagnosis and we should be able to see this small group relatively quickly. When it is said the important time for treatment is in the first ten years of life, that is true for that group. However, the most important time for treatment is probably the first five years of life because that is when children's lungs are developing. We call it the golden age of alveolar development. If you can get to a child during the time, there are two potentials. You can reassure the family in some ways that this might not be a curve that will develop at all. If we can treat them, then sometimes we can even reverse it.

The second group is the neuromuscular group, and this can occur at an early age as well. Most of these children need surgery to help with seating and with pain. They can have their surgery in a controlled way, and that is probably the biggest group we deal with in the acute hospitals.

The final group is the idiopathic scoliosis group in adolescence. In Cappagh, we have that group under control.

It is the one group we have under control through our rapid access service. We have decreased our waiting time from 18 months to four weeks. We have decreased our time for surgery from about a year and now we just give families a date when it suits them. I have the biggest waiting list in Cappagh still, but it is only five or six. We are in control in idiopathic scoliosis.