Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

We very often hear reference made to the fact that seven years ago the then Minister for Health, Deputy Harris, gave a commitment that no child would wait more than four months for spinal surgery. It is worth reminding ourselves of that fact and the empty promise that was made. The same commitment was given by the current Minister for Health two years ago, as I am sure he will recall, but the commitment has never been honoured. In fact, the situation has only got worse. We now have 327 children on the waiting list for scoliosis surgery. That is a 5% increase on 2017, when the former Minister, Deputy Harris, first announced his target. All these years later, what is the target for children with scoliosis now? It seems that this Government is simply incapable of getting to grips with this issue. Last year, the Taoiseach said that he wanted Ireland to be the best country in Europe in which to be a child. Those words ring very hollow for children with spina bifida and scoliosis.

The Government’s inaction and its inability to get to grips with this issue have a direct impact on the health of the children to whom I refer. It is not abstract for them or their families. The longer these children wait, the more their spines curve, the more their organs are crushed and the more their chances of survival diminish. This is why real strategic action is required. Such action is well overdue. This cannot be allowed to become a perennial problem. This Government should be doing everything possible. If necessary, it should identify other sources of funding. There has been much criticism of the different directions in which funding is going. There is a great deal of money available in this country. If the matter we are discussing is not a top priority, I do not know what is. After all, we are talking about some of the most vulnerable children in our society. It is frankly unforgivable that they are being denied their most basic rights. In a rich country like ours, which has a surplus of €8 billion, there can be no justification for this failure to provide the necessary services. Parents and children should not have to fight and plead for treatment, yet that is exactly what they have been forced to do for years.

Again and again, we are both disturbed and moved by the plight of children waiting years for surgery. They share their stories in an effort to secure treatment and surgery and advocate for others but they should not have to do that. They should not have to take to the streets again. This Government has left them with no other option. These are some of the most medically challenged children in the country. They have been repeatedly failed by successive Ministers for Health and CHI. Trust has completely broken down since last year’s revelations about spinal surgeries in Temple Street. Many thought that scandal would surely be a catalyst for change - for an accelerated response - but, regrettably, that has not happened.

At the beginning of this month, we learned that the independent review into Temple Street had been widened to include 17 further cases of concern. While this will inevitably delay the completion of the report, it is very disappointing that no updated timeline has been provided. I ask the Minister to do that tonight. Last week, I received a reply to a parliamentary question from the Minister about this matter. He seemed to be using the independence of the review as some kind of excuse for not providing an indicative timeline. However, when I raised the reporting timeline with him last September, he said, "nobody will be waiting a year for a view from Dr. Nayagam and this review". He also committed to interim reviews and said that the review was being set up in such a way as to ensure that pressing clinical issues would be reported on in 2023. Again, those were just empty promises. Even with the discovery of new cases, I cannot understand why we have not heard anything from this review. What happened to the interim reports?

I welcome the Minister’s commitment to establish the task force, the structure of which must be informed by the views and position of advocacy groups. The Social Democrats fully support the call in the motion for the task force to be independent of CHI management and for it to have a mandate to listen, engage and act on the advice and concerns of parents, patient advocates and clinicians.

I wish to state my strong support for the inclusion of paediatric urology in this motion and for the specific call for a suitable location for the elective paediatric urology service. I heard Senator Tom Clonan speak about the waiting lists relating to this matter last week. He gave a harrowing account of children with disabilities being left to languish on urological surgery waiting lists while their urinary continence, faecal continence and sexual development suffer due to a lack of intervention. That is completely unacceptable. How can the Minister stand over a situation where 81% of children are waiting longer than the Sláintecare target time for inpatient paediatric urology, while 72% are waiting longer than the target time for outpatient paediatric urology? That is indefensible. This is clearly a completely overlooked area of healthcare despite the severe implications for patients as a result of inadequate services. They can include the loss of renal function, loss of genital and sexual function, infertility, higher rates of urological cancers, increased levels of morbidity, psychological disorders and in some cases, even more serious outcomes.

This area of medicine is a very sensitive and personal one. That is why we need appropriately trained and qualified paediatric urologists. In 2019, a model of care for urology was published by the Royal College of Surgeons in Ireland in partnership with the HSE. Among its findings was that Ireland had one of the lowest ratios of accredited urologists in the western world. At the time, Ireland had 37 urologists. While the number had increased to 51 by 2022, that still only represents 40% of what New Zealand had and 20% of what Denmark had. Both these countries have populations similar in size to Ireland. That same model of care recommended national and regional centres of excellence for sub-specialist urology such as complex paediatric urology. To deal with the deficit in paediatric urologists, the report also recommended that all new or replacement urology posts for the next 15 to 20 years have a component of paediatric urology in the job description. Can the Minister please let us know the status of this report and the implementation of these recommendations? One would be forgiven for assuming that this is just another report left to gather dust on a shelf. There are just too many devastating impacts of this Government’s inaction on paediatric orthopaedics and urology. Taken as a whole, they amount to one thing - a theft of childhood. While these children wait in limbo and get sicker and sicker, they are denied many aspects and parts of a normal childhood.

Year after year, this State has failed utterly in the context of its obligations to these children. All the while, they continue to suffer unimaginable pain. There can be no further excuses. It is time for action and accountability.

The countermotion that the Minister tabled is extremely disappointing. He does not seem to grasp the scale and the nature of the challenge he is facing or the action he needs to take. Nothing less than urgent action and delivery on his promises will be acceptable.

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