Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Deputy Frank O'Rourke for raising this important issue and giving me an opportunity to outline to the House the current position on this matter. Tallaght Hospital adult service is part of the Dublin Midlands Hospital Group and Tallaght is the principal provider of elective orthopaedics in the group. The hospital's spinal orthopaedic service provides emergency and elective access for varying acute and degenerative spinal conditions with a tertiary referral base.

The hospital service for chronic degenerative disorders includes surgery for conditions such as sciatica resulting from spinal degeneration, degenerative spinal deformity, bone fragility-related disorders of the vertebral column and spinal fractures. Patients with abnormal curvature or deformities of the spine may also require corrective surgery. Approximately 30% of spinal patients operated on in Tallaght Hospital are patients who transition from Crumlin children's hospital. In cases involving the severely disabled, complex reconstructive surgery provides real capacity for improvement in life quality, pain and spinal function. The service at Tallaght Hospital includes a pioneering physiotherapy-led back pain clinic screening, which ensures that only 20% of the GP referrals require onward referral to a consultant-led clinic. There are also linkages with pain management services so that patients have access to pain management clinics.

It is acknowledged that spinal orthopaedic activity levels at Tallaght Hospital have fallen in recent years. There has been a reduction in consultant staffing numbers in this sub-specialty area due to consultant departures and difficulty in recruiting replacements. This is an important issue. In an effort to address inpatient and outpatient spinal orthopaedic waiting lists, an additional half-time consultant was appointed in late 2014. This appointment has assisted in managing emergency admissions and in running additional waiting list clinics. In 2015, €1 million was provided by the HSE to fund 100 degenerate spinal surgeries. An additional consultant is due to start work at the hospital in July 2017 and it is expected that this appointment will assist in addressing the hospital's capacity deficit in the long term, particularly in respect of the issues the Deputy raised today.

Furthermore, the winter initiative funding for 2016 and 2017 includes a €7 million fund for a targeted waiting list programme for orthopaedics and spinal and scoliosis procedures in designated sites, including patients on the Tallaght Hospital waiting list. This includes €2 million provided specifically for scoliosis patients to treat the 39 adolescent patients on the Tallaght waiting list and additional 15 to 20 paediatric patients by the year's end. I am aware that the long-term strategy for Tallaght Hospital is to provide spinal degenerative surgery, with a gradual transfer of the adolescent scoliosis surgery from Our Lady's Children's Hospital, Crumlin, to the new children's hospital.

Hospital groups must focus increasingly on networks of service provision, with smaller hospitals managing routine, urgent or planned care locally and more complex care managed in the larger hospitals, such as Tallaght Hospital.

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