Martin Daly (Roscommon-Galway, Fianna Fail)

Every one of us in the House has met families whose lives have been shaped by scoliosis or spina bifida. These are families who do not have the luxury of waiting until next year for improvements. They need treatment now. As a GP, I have seen how timely spinal care can change the entire trajectory of a child's life, and that perspective shapes what I want to say today. Yes, progress is being made, but we have a long way to go before any of us can be satisfied. We need to be honest. Too many children have waited too long for spinal procedures. While some indicators are now moving in the right direction, nobody should pretend that the job is done or that families can suddenly feel reassured. They do not, and I do not blame them.

Up to the end of October, 446 spinal procedures were completed, slightly more than last year, but demand is rising even faster. Some 462 new cases have been added to the list this year, which tells its own story. We are adding cases more quickly than we are clearing them. Nonetheless, there are improvements. Some 68% of children are now waiting less than six months compared to 56% a year ago. The number of those waiting over a year has halved and outpatient lists have fallen by almost 50%. These are signs of a service that is trying to pull itself out of a very difficult period, but it is also a reminder that the gains are fragile and that the system is still heavily stretched, especially when one retirement or one ICU bed shortage can derail a week’s worth of surgeries.

I welcome the hard work of clinicians, the spinal management unit, the multidisciplinary teams and the new transition pathway for adolescents because it is their efforts that are turning numbers into reality for families. However, I will also say this. They need more support, more capacity and more consistent communication structures. Families cannot be left chasing letters, clarifications and updates. The various reviews, the HIQA report, the Boston review, the internal examinations and the ongoing Nayagam review are not comfortable reading, nor should they be. If anything, they show that oversight did not come soon enough. The audit into governance and equity of access is essential and, frankly, overdue. Families deserve transparency, not a maze of inconsistent processes and varying standards. The planned statutory inquiry into spina bifida and complex scoliosis services is a necessary step. It is not a tick-box; it is not a gesture. It must be a turning point.

I want to acknowledge the families and advocates whose persistence has brought us to this point. They have shown more courage and patience than any system should ever demand of them.

As for the integration of CHI into the HSE, it may well be the right long-term move, but let us be clear: structure alone will not fix culture. Governance changes must be matched with accountability and day-to-day improvements must be felt by real families. Progress is real but it is not enough. We need more theatre capacity, more consultants, better planning for surgeries and demand, and communication that treats parents as partners, rather than supplicants. If we want families to regain trust, we have to earn it. As a GP and someone who believes the health system should serve the most vulnerable first, I will continue pushing for urgency, honesty and accountability because these children deserve nothing less.

See this speech in context