Professor Damian McCormack:

I will answer this question as best I can. We have to take a national look at this. We are employed in Cappagh and Temple Street and we do the best we can there with the resources we have. Each week I do a national clinic in the Central Remedial Clinic, CRC, for neuromuscular disability. Those patients are supposed to be from the local catchment area, but they are coming from the entire country. As a paediatric orthopaedic surgeon, I can see a patient with a spine problem in the CRC and I can operate in Cappagh. There is no equivalent of me anywhere on the west coast, the midlands or in the north east. There used to be. Twenty years ago, there was a paediatric orthopaedic surgeon in Sligo. There was one in Galway, in Limerick and in Cork. These were very well trained, very hard working consultants who ran the local service to a very high level. Only high-risk children with difficult issues were sent to Dublin. Nationally, now, that is all broken down. We do not have a paediatric orthopaedic surgeon service in Galway. A locum service is being provided out of Crumlin, which is unsatisfactory when you think about it. We do not have a paediatric orthopaedic service established in Limerick. They are talking about dropping it completely. Sligo is struggling. The north east, which recently built two new theatres for paediatric surgery, does not have a paediatric orthopaedic surgeon.