Áine Brady (Kildare North, Fianna Fail)

I welcome the opportunity to respond to the Fine Gael motion. Along with my colleagues, I would like to categorically refute the allegation that critically ill children have had essential treatment withdrawn. Our Lady's Children's Hospital is recognised internationally as a centre of excellence in paediatric care. Crumlin always has been, and continues to be, totally committed to the ongoing care of all children.

I also welcome the announcement by the hospital that further ward and theatre closures, which had been proposed for July and August, will no longer be necessary. I understand from the HSE that this decision was based on the financial performance for the first five months of 2009, which has strongly indicated that the hospital should achieve a break-even position at year end.

Deputy Reilly raised a specific issue in last night's debate regarding surgery of children with scoliosis. I would like to respond to this matter. The debate about current services for children with scoliosis must not be reduced to over-simplified discussions about angles of spinal curvature. As the health spokespeople know, the decision on whether to operate on a child must take into account many factors and is a complex weighing up of the benefit of the treatment against the risks inherent in surgery of this kind. The decision to operate on a child will depend on many other factors, such as whether the family and surgeon wish to wait until the growth phase has ended to assess severity at that stage. It will also be influenced by the possibility that anaesthetic risk may increase with age, such as with muscular dystrophy, and this will lead to much earlier intervention with curvature of possibly only 20%.

I understand the HSE met yesterday with the three paediatric hospitals, including Temple Street, which also has extensive experience in this area, with a view to making inroads into the waiting times for scoliosis patients. Crumlin has been asked to revert as a matter of urgency to the HSE with proposals to address the needs of scoliosis patients between now and year end. The Health Service Executive, HSE, will consider these proposals as soon as they are finalised.

The real challenge in paediatrics is to maximise the efficient use of all health care capacity in Dublin and throughout the country. Paediatric services in Crumlin, Temple Street and Tallaght hospitals must increasingly work in a co-ordinated, shared and efficient fashion to prepare for the eventual coming together of the three institutions into one national paediatric hospital. With this in mind, the HSE is actively pursuing ways in which services in the three hospitals can be best co-ordinated, to avoid unnecessary duplication and to achieve savings that can be put back into patient care. For example, the three children's hospitals in Dublin have agreed and developed a model for the development of a joint department of paediatric surgery. The clinical network in the three hospitals will make the best use of the resources available and will ensure a single system of care. A recruitment process is underway to recruit three replacement surgeons that will then give the joint department a complement of seven surgeons. Currently five are in place with another is due to retire shortly.

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