Peter Fitzpatrick (Louth, Independent) | Oireachtas source

Children with a range of needs rely on the orthopaedic service of Children’s Health Ireland, among them children with spina bifida, scoliosis, hip deformity and other orthopaedic needs. The complex patient needs of these children remains at the forefront of service provision. However, waiting times for many hospital procedures and appointments are unacceptably long. I remain acutely aware of the impact this has on children and their families, especially for time-sensitive procedures where time is a crucial factor in ensuring these children have a positive outcome from their surgeries. The length of time these children have to wait not only impacts on their quality of life, but there are major concerns that the vast majority of children currently waiting for care will age out of paediatrics untreated.

In 2022, an oversight group, co-chaired by the Secretary General of the Department of Health and the CEO of the HSE, evolved into the waiting list task force. This task force produced a comprehensive 2022 waiting list action plan which set out high-level targets for waiting list improvement, including dedicated funding for service reform, patient pathway improvement and important significant additionality to substantially reduce the backlog of patients waiting. This plan was to be funded in the context of the wider waiting list action plan for 2022 and included additional activity to reduce the spinal orthopaedic waiting list through the use of theatres at Crumlin, Temple Street, and Cappagh hospitals. Additional capacity was also promised in the private sector to work towards reducing paediatric orthopaedic waiting times.

I acknowledge that for 2023, €123 million was allocated for the delivery of the HSE waiting list action plan, including priority areas such as spina bifida and scoliosis. This should have facilitated, improved, and broadened paediatric orthopaedic service delivery and access to specialists in the area of neurodisability, neurosurgery, orthopaedics, urology, occupational therapy, physiotherapy and neuropsychology. However, as of 13 February, there are 327 children listed as waiting on a scoliosis related surgery with Children's Health Ireland compared with 312 in February 2017. It is evident that waiting lists are only getting longer and these resources are not being utilised efficiently. As a result, Government has failed to deliver on its health and social care commitments to children, whereby children's healthcare services are not operating at a satisfactory level, as evidenced in the Sláintecare waiting list metrics.

Any delay in lifesaving orthopaedic surgeries will, and has, caused serious damage to children. This is also true for urology services whereby delays in urology surgery are causing irreparable damage to children’s organs, such as their kidneys, ureters, bladder, prostate, testes and genitalia. For example, some are facing renal failure as a result of not getting treatment in a timely manner. I am often approached by parents regarding problems with orthopaedic surgery, especially waiting lists for scoliosis surgery and urology surgery. The longer children wait for treatment, the more serious the problem becomes, the more extensive is the surgery required and the higher the cost.

The funding must be put into areas that will make a difference for the children who urgently need surgery. Funding allocated for orthopaedics, with a very clear focus on paediatric spinal work, needs to be prioritised and implemented in these areas. It is evident from last week's Joint Committee on Health that the Minister for Health is not satisfied that the €19 million investment fund has been allocated according to his clear direction on prioritisation for orthopaedics. Therefore, an independent task force, independent of CHI management, must conduct a comprehensive review of scoliosis and spina bifida services, including funding implementation and mismanagement, transitional care, post-surgical specialist rehabilitation, and full and appropriate access to community services. This is important to establish a sustainable public model of delivering specialist care for children.

Seven years ago, the Government made a commitment that no child would wait more than four months for spinal surgery. This commitment has been repeatedly broken, with devastating consequences. Everything we do must be to ensure we have the best possible services for children, including spina bifida, scoliosis and other paediatric orthopaedic services. The system is not working. Action is required immediately and not down the road. The focus now needs to be on ensuring children get access to services as quickly as possible and that the waiting lists which had been there for many years are permanently eradicated.

Children deserve the best possible services. They should come first. It is not right that children have to wait for so long for surgery. It is not only impacting the children but their whole families. I recall how years ago the then Minister for Health, James Reilly, said the money should follow the patients. I am asking the Minister what the problem is? There seems to be plenty of money in the budget. Is there a problem with the doctors and the surgeons? What is the problem? This does not seem to be a problem in other countries but we seem to have a problem. Please look after the children. I spoke today about strokes. A couple of weeks ago I spoke about hearts. I am a firm believer that your health is your wealth. Children should come first and these children should be looked after.

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