Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank all colleagues here for the attention they have given to this really important matter. I also acknowledge all upstairs looking down on us. They have been here all day. They have travelled far and wide to be here to tell their stories. As the Minister said earlier, he had to leave early. He is attending a meeting with the chief executive of the HSE, Bernard Gloster, and the HSE board at 7.30 p.m. or 8 o'clock - I am not sure which. That is why he has left. He has assured me that he will raise this as a priority.

We are making progress with the waiting lists for spinal surgery despite the significant increase in demands and referrals compared with previous years. We have seen a 13% reduction in children waiting over four months for spinal procedures at the end of 2023 compared with 2022. We have also seen a 5% reduction in the number of children waiting for spinal procedures, excluding suspensions, at the end of 2023 compared with 2022. However, we are not for a moment saying that is good enough.

Funding has been provided to deliver these vital orthopaedic and neurology services for children. Some €19 million was committed to scoliosis and spina bifida as a priority in both the 2022 and 2023 waiting list action plans to increase activity and reduce waiting times for children. That is all anybody wants and that is all everybody in this House wants: not to see children suffering, not to see children in pain, not to see appointments cancelled, as Deputy Harkin said, not to see the situation whereby people get an email saying they will be looked after in four weeks' time and then that is cancelled. That is heartbreaking for any parent. I am a mother of three. It is heartbreaking for any parent to try to deal with that.

I welcome the fact that the Minister, Deputy Donnelly, has announced tonight that there will be an internal audit team because our job as Ministers and Ministers of State in government is to try to secure as much funding as we possibly can at budget time in order that services can be delivered. We expect the services to be operationalised by whoever is delivering them. If the full amount that was committed to scoliosis and spina bifida as a priority has not been spent, that is certainly not good enough.

The funding has supported the recruitment of significant additional healthcare professionals, including nurses, consultant doctors, anaesthesiologists and radiographers. It has also supported the opening of a fifth theatre in Temple Street and an MRI in Crumlin, along with additional beds. At the time when all these were opened, we were very hopeful. Additionally, this investment has supported more capacity through national outsourcing at Cappagh, and this has resulted in an increase in activity.

The number of spinal procedures undertaken in 2022 was 509. In 2023, 464 procedures were carried out. This represented a 34% increase and a 22% increase, respectively, compared with the 380 procedures carried out in 2019. Despite undertaking a record number of spinal procedures over the past two years, the expected reductions in the waiting list were offset by a significant increase in demand and referrals compared with previous years. We have seen a 42% increase in cases presenting compared with 2018.

There are currently 288 children on the waiting list for spinal procedures, including suspensions. The latest National Treatment Purchase Fund waiting list figures for January 2024 show that there are 890 patients waiting for an inpatient or day case orthopaedic procedure at Children's Health Ireland. Since December 2023, there has been a decrease of 4% in the number of children waiting outside the 12-week target for orthopaedic treatment. There are 476 patients waiting for an inpatient or day-case urology procedure at Children's Health Ireland. Since December 2023, there has been a decrease of 5% in the number of children waiting outside the 12-week target for inpatient or day-case urology treatment. The Minister and I accept that waiting lists for scoliosis and spina bifida services are far too long.

The Minister intends to convene a dedicated stakeholder task force. He met with patient advocacy groups yesterday to explore the terms of reference for this task force. A dedicated paediatric spinal surgery management unit has been established in Children's Health Ireland. This unit is focusing on the management and delivery of spinal surgery, including reform of the waiting lists. Work is under way on a paediatric spinal care programme of work. This programme includes actions being taken to address the current waiting lists, such as the implementation of identified improvements to the management of spinal surgery and the waiting lists. There is also ongoing work as regards outsourcing options for clinically suitable children in order to increase capacity for this vital service. I know work is under way in respect of one facility in Northern Ireland. It is being explored in the context of outsourcing options for clinically suitable children. The programme is also looking to the future, and work has begun to design a dedicated paediatric spinal service for the new children's hospital, which this Government is committed to seeing open as soon as possible.

As I said, scoliosis and spina bifida were identified as a problem in 2022 and 2023 in the waiting list action plan, and €19 million of current and capital funding is committed to target these waiting lists by improving the patients' journey and creating additional capacity. The investment has supported an increase in the number of spinal procedures undertaken in both 2022 and 2023, and scoliosis and spina bifida services will continue to be priority areas under the 2024 waiting list action plan.

Despite undertaking a record number of spinal procedures over the last two years, the expected reductions in the waiting list were offset by a significant increase and demand in referrals compared to previous years, with a 30% increase in additions to the spinal fusion surgery list in 2022 and a 42% increase in 2023. In recognition of this significant increase in demand, the HSE, the NTPF and CHI are exploring all options to increase capacity for this vital service.

I reiterate that the Government acknowledges that waiting lists for scoliosis and spina bifida are too long and that many patients have been waiting an unacceptably long time for care. There is nothing worse for any parent than to be looking at their child in pain. There is nothing worse for any parent than to get that letter in the post to tell them their child has gotten a referral date and then the date is suspended. There is nothing worse for a parent than when their child's surgery is authorised and there may not be sufficient nursing staff to look after the child, especially when it is very complex care.

I will continue to work with the Minister for Health to do my utmost to make sure we can make progress on this matter for all those children who are waiting. I reiterate that this issue is not financial. The Minister, Deputy Donnelly, has allocated a significant amount of funding to CHI over the last two and three years to make sure that children should not have to wait any longer than necessary. Unfortunately, even though the funding was allocated, we have seen such a demand for services that waiting lists have grown. I accept that this is not good enough. We are committed to improving waiting times for children seeking scoliosis and spina bifida care. All we want to do is benefit the children and families who need this care.

See this speech in context