Marie Sherlock (Dublin Central, Labour)

I very much welcome our having these statements today, and the big breakthrough that has happened over the past week in terms of the agreement to the inquiry. Obviously, we have to see what the exact form of that inquiry will be. We have seen scandal after scandal in spinal services within CHI over many years. It is very welcome that there will now be a proper investigation of that. I know we have had statements before and have paid tribute to the parents of Harvey Morrison Sherratt but in particular, I pay tribute to their immense dignity and incredible strength in dealing with the revelations they have had to encounter over the last fortnight and in the face of their absolutely devastating loss. How badly failed they were by the health system that should have been there for their son has played out so publicly. I am also hugely mindful today that when we talk about spinal services, for some children and young adults it is now too late because of the failures within the system. They carry those questions for the rest of their lives about what could have been if their treatment and care had been different and if those failures had not been present. To those families who are currently fighting for surgery, of whom there are many, there is a bitter irony that the families of these children, some of the sickest children in this State, are having to put up the greatest of fights for appropriate care. That is wrong.

While we talk about the patient, the child and the family at the heart of this, we know there are many nurses and doctors who are going day in, day out into a very difficult work environment and trying to do the best by their patient. Unfortunately, however, there is a system and there are some decision-makers and clinicians who have failed in their duty. That is what needs to dramatically change. I do not think it is an understatement to say what has happened has been a national scandal. When we look back in ten or 20 years, we will wonder how children have been so badly failed. These are children who have been in the health service for a long time. Their conditions have been recognised for a long time, yet the systems of care have failed so badly.

In that context, I welcome the Government's announcement that it will have an inquiry, but I have to ask what it will lead to. To my mind, it is not just about what has happened but what is currently happening within CHI. If we think back - other Deputies have referred to this - over the past eight years, we have had at least five reports into the failures within CHI. There was the Dixon report, which now seems to have been disowned by CHI because it was then obviously known as Temple Street. There was the Boston report in 2023. There was the HIQA report, which was commissioned in 2023 and published earlier this year. The Minister referred to the Simon Thomas report and, of course, we are awaiting the Nayagam report. Between the Boston report and the HIQA report, there are 59 recommendations as to how to overhaul services within CHI. Those are recommendations that all arise from the same dysfunction and the lack of proper processes, toxic culture, appalling management and lack of collegiate responsibility.

The reports themselves should be sufficient to bring about necessary change, but the Government's agreement to an inquiry is an admission that they are not. The devastating allegation that Harvey Morrison Sherratt was moved to a palliative care list is a really distressing new low for CHI. If it is true, how could anybody in good conscious make that change and not follow up as to how that child was doing? Time and again, there is this bitter irony that we are not talking about thousands of children. We are talking about a small number of children who have been so badly failed. One parent whose child has now passed away said to me that her child became a political football between the egos of consultants. While, as I said, there are some really good spinal surgeons out there working in our system, we have to ask how we have got to this place.

With regard to what is happening now, we know the list is longer this year than it was last year, as the Minister alluded to, and there are 139 on the list now. There is an element of us not even running to stand still. We understand that no child has been scheduled for treatment abroad over the past number of months, and we have heard the Minister's frustration on this. A big deal was made about referring children to Great Ormond Street Hospital or Morgan Stanley hospital. One family have told me their child has been on the waiting list for 12 months. The child has been told they need surgery. The family believe the child can travel. They have not been offered the option to travel and when they spoke to their surgeon, they were told that surgeon does not have a list in the Blackrock Clinic and, therefore, could not refer that child to the outsourced option, whereas that option appears to be available to other children. How can we have a dysfunctional system where one surgeon decides who gets outsourced, whereas another surgeon cannot? This is the dysfunction at the heart of CHI.

With regard to this inquiry, so much is riding on what it will produce where it seems a number of reports have failed. Obviously, it is really important that it will have compellability because, ultimately, any inquiry is only as good as the fulsome participation of the clinicians and management. There are serious questions as to whether they will participate willingly or not. I, and we in the Labour Party, believe that compellability will be important. It is vital that the advocacy groups be there all along the way. I pay particular tribute to the tenacity and perseverance of the Scoliosis Advocacy Network and the Spina Bifida and Hydrocephalus Paediatric Advocacy Group. Many of those parents already have so much on their hands trying to care for their child. They are fighting for their family but they are doing much more than that. They are fighting for other families who do not have that capacity. It is absolutely exhausting and they have been at it for so many years.

With regard to getting truth, accountability and justice out of this inquiry, the critical thing for us is that we believe a twin-track process needs to be in place.

There will have to be a series of stage reports. First, we need a module on whether CHI is implementing the change that it has promised to deliver. In effect, we need a mediated process whereby the record is set straight between clinicians and parents as to the status of the child's care. All too often parents come to me and to other Deputies here who feel gaslit, who feel they are not being told the truth and who feel they are being told conflicting stories by the clinicians and the health staff that they interact with. I hear what the Minister said regarding the process that is up and running with regard to that lady who is already interacting with those families but it needs to be a mediated process between the clinicians and the families because ultimately many of the families feel they are not getting the truth they so rightly deserve.

The second key issue is the investigation into the cases of children who passed away because of the failings in care and those children for whom surgical intervention was too late. There will inevitably be allegations that will lead to litigation and so on. It will potentially go on for a very long time. We believe the onus is on the Minister to ensure that this inquiry will deliver the answers that we, the public and particularly the parents, so much need. Our request to the Minister is that this inquiry can get those answers, which may turn adversarial, while also ensuring that the system improves. There are very real question marks about how that can happen with a very limited number of staff at the heart of these questions over the coming years. That will be no easy task. We in the Labour Party have said for many months now that the HSE needs to take over the board of CHI. We very much welcome the Minister's move in that regard. We urge her to move with speed on that issue. It is no silver bullet but it will be progress. Ultimately, the biggest question in my mind now is getting this inquiry right, getting the answers and making sure that systems improve at the same time. The people needing to provide the answers will also have to improve their act with regard to the services.

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