Marie Sherlock (Dublin Central, Labour) | Oireachtas source

I very much welcome that we are having these statements. It is important to say that over the past number of weeks, I have spent a good deal of time talking to staff of CHI - doctors and nurses - and many of the parents of patients. As we all accept, every day brilliant work is done across the three sites in question. I know that as a parent who has had to use Temple Street hospital on a number of occasions in recent months and also as a public representative. However, that brilliant work is being overshadowed by the practices of a few and by the systemic failings we are seeing within CHI. The almost 4,000 staff of CHI obviously do not want to be in the eye of the storm. They want to get on with their work, but we have to make good. We have to resolve the systemic failures that exist. I refer here to the failure by the board to institute proper and basic processes, the failure on the part of the board of management to deal with poor staff culture and the failure on the part of the Government and the HSE to make good on commitments to put in place resources in order that children get the care they need in a timely fashion.

I come from the perspective that I usually want those in leadership positions to own their own failures, but I am not so sure about the current board of CHI. Five of the 11 members of the board have served since 2018, one has served since 2020 and there is just one clinician in that cohort. There have been appointments since the start of the new year. I very much welcome that, but we need to see serious changes on the board this year.

Section 12 of the Children's Health Act makes very clear that:

Persons appointed to the Board shall be persons who have, in the opinion of the Minister, experience or expertise in matters connected to the functions of Children’s Health Ireland or to corporate governance and management generally.

The care of the three children that prompted the HIQA report reflected the reality that both the systems within CHI and the board failed. Obviously, there are now clear questions about the capacity of the board to oversee and implement the very onerous recommendations that were put forward by HIQA and to oversee the transition to the new children's hospital. We know there are 19 recommendations to be implemented. I heard the Minister say that 90% are either complete or in progress. The fundamental question is when will we see the full completion of all those recommendations. When I look at them, I can see that they are exceptionally onerous. They demand organisation-wide review, reform and systemic change. The question is does the Minister believe the current board is capable of ensuring that the implementation of those recommendations will be completed.

There is a second but related issue about whether having a separate board for CHI makes any sense at all when the HSE is now compelled to have a much greater organisational oversight of the activities of the three hospitals that make up CHI. I say all this because the use of unregulated springs is one matter but the potentially even greater scandal coming down the tracks relates to the unnecessary hip operations. If there is anything to come out of this debate, it is that whenever the report into the unnecessary hip operations is published, it needs to clearly show the number of surgeons involved, whether what was being done was systemic or whether it was just about the sins of just one individual and whether it was private activity that drove these surgeries? As previous speakers indicated, people's faith in CHI and in the individual hospitals very much rests on that.

In recent weeks I have spoken to many of the families that are going through the agonising wait for scoliosis correction surgery. I previously spoke in the Dáil about Daniel Collins, a 14-year-old boy who lives in Tralee, County Kerry. Never in a million years did his mother want to go public about this matter but because her child has been on a waiting list for more than 14 months, he is now facing two surgeries. Daniel's mother was forced to go public because the surgeon could not offer a single date. This Friday, we will hopefully have progress and have a date for Daniel's surgery, but there is a critical issue here about how we have one child who is has been waiting for 14 months. We know there are approximately 132 patients waiting for surgery but that only 47 procedures are planned. We also know that another 40 children go on the surgical waiting list each month. My question to the Minister relates to how those care pathways are being dealt with over the short, medium and longer term.

I heard what the Minister said about Great Ormond Street Hospital, the Morgan Stanley Children's Hospital in New York, Cappagh hospital and Blackrock Clinic, and we all get the urgency of the situation for these children. I support what is happening but it does not sit easy with me, particularly because of the cost involved. We understand that €600,000 is the cost of relying on surgical services in Morgan Stanley Children's Hospital in New York. That does not sit easy with me. If a child needs surgery, however, then that is what we need to put in place because of the massive backlog.

In the meantime, what is being done to build capacity here? I am seriously concerned that capacity is not being built fast enough and that there will be an over-reliance on services outside the country or within the private sector here. As the Minister acknowledged, for many families, travelling abroad is not an option. I spoke to one family last week who told me that because of the oxygen system their child currently has, the aviation authority will not allow that child to even board a plane. Of course, travelling is not going to be an option for that family. We have to ensure that while putting short-term fixes in place, we build the necessary capacity.

The second key issue is that we have seen the opening of Saturday clinics for scoliosis sufferers. Again, that is to be welcomed. When I talk to families, particularly those with children with spina bifida, however, they say they are not getting appointments for those clinics. Other children whose curvatures are far less severe may be getting those appointments. We have to be informed as to who precisely is getting appointments at those Saturday clinics and make sure that those with the worst curvatures get the care they need. When I asked one parent a number of weeks ago what is next if we do not get surgery here, she informed me that it would be palliative care. That is the reality. Children have already died. Others could die if they do not get this surgery.

The third key issue for me relates to the care pathways that have been put in place. From talking to certain parents, I understand that such are the cultural and organisational difficulties, particularly in Temple Street but also in Crumlin, that there is an issue about the logistics of when a child undergoes a surgery. The surgery takes place in Crumlin, the specialists travel there from Temple Street and then the child has to be transported back to Temple Street. We have this issue therefore - I would like to get clarity from the Minister as to the extent to which that happens - of very vulnerable patients being ferried by ambulance between Temple Street and Crumlin, all because of an organisational dysfunction relating to consultants.

That has to end and it needs to be cleared up, particularly because if a child has spina bifida or a shunt and if that shunt fails for whatever reason, we are talking about minutes in terms of being able to treat them. The thought of putting them into an ambulance unnecessarily beggars belief.

The Minister said earlier that scoliosis patients account for 1% of all patients across CHI, and there has been a huge amount of attention on scoliosis sufferers, but we have to look to the others. When I look at the wait times for some of the specialties, it is quite distressing to see the length of time some children are waiting, not for appointments but for actual surgery: paed ENT, 313 days; dental surgery, 305 days; developmental paediatrics, 322 days; neurology, 228 days; nephrology, 258 days; dermatology, 300 days; and orthopaedics, 319 days. We need to make sure our eye is not taken off the ball for those other patients in getting the procedures and surgeries they require because they too are very much suffering.

The last thing I want to say relates to the children's hospital.

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