Mr. Connor Green:

As I went on to outline, it relates to the children with spina bifida we are trying to look after by maintaining their walking and their being able to sit in a wheelchair, and by keeping them out of pain in order that they can go to school. These children have no sensation in their feet, so if they develop a foot deformity, it will immediately break down into a pressure area and a sore.

We are trying to allow a child to go to school to be educated because these are bright kids. The next group is the cerebral palsy group. These children have sensation all the way down and so when they get a foot deformity, they cannot walk because of pain. Again, these are bright intelligent children who should be able, through their abilities, to help Ireland. I could continue with all the groups of children with additional needs, but there are also the other children who are completely medically well. Normal children are born in Ireland every day and have a silent diagnosis of hip dysplasia because we do not have a screening programme.

We did a review with the Cappagh National Orthopaedic Hospital Dublin, which showed that 40% of people under the age of 50 needing a hip replacement have hip dysplasia. Because we do not have the screening programme, I think the hip replacement cost for an under 50-year-old is probably about €5,000 for implants. I think it is about €10,000. I would not be held to those numbers because I am not an adult surgeon. We do several operations per week and I believe our implant costs €50. Therefore, it is an enormous cost to the State and to the family. Anyone who has a hip replacement by the age of 50 will definitely get one or two revisions before they are finished.

We have not even started talking about children who might just have a bit of a curly toe or a lump that needs to come off. Those children are completely lost. We have not said anything about our trauma service. We are not talking about the children who come in every week with fractured arms, infections etc. If there was a major incident in Dublin today involving children, we do not have the ICU beds for them to go to. We have no beds in Temple Street at the moment. We have no redundancy in the system. We could talk all day about each aspect of paediatric orthopaedics.

I want to be clear in this. I do not blame anybody within the management structure of CHI for the failings in this. We just do not have enough paediatric resources and they need to be put in place. I believe Eilísh Hardiman is a very good CEO who is genuinely trying to help. However, we are really stuck because everybody is focused on the new hospital. Everybody thinks this new hospital will save everything and it will not. We have been talking about a new hospital since the 1960s. The Mater was supposed to happen and was going to save everything. Children keep getting sidelined. Entire generations of children are now grown up. We need to remember that the children are paying for all our pensions and will support the State in the future. If we continue to neglect them now for small investments, it will be a problem.