Bobby Aylward (Carlow-Kilkenny, Fianna Fail)
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11. To ask the Minister for Health if he will report on the progress regarding the commitments he made in respect of reducing surgery waiting times for children with scoliosis; and if he will make a statement on the matter. [40786/17]

Bobby Aylward (Carlow-Kilkenny, Fianna Fail)
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I wish to ask the Minister for Health if he will report on progress regarding the commitments he made in respect of reducing surgery waiting times for children with scoliosis.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Aylward for raising this important matter. It is one the Deputy has consistently raised with me in this House and I know he has taken an active interest in it. The HSE is actively implementing the action plan it developed to ensure that no child will be waiting over four months by the end of the year for such surgery and is focussed on maximising all available capacity both internally within the health service and externally to achieve this target.

Additional nurses are now in post in Crumlin and Temple Street. An additional consultant orthopaedic surgeon commenced in Crumlin earlier this month. In 2017, up to the end of August, 202 scoliosis procedures were carried out in the two children's hospitals. That compares with 142 in those hospitals in the same period last year, representing a 42% increase in surgeries between the two hospitals in one year. Since February 2017, patients are also being transferred for treatment to the Mater, Cappagh and Stanmore in the UK. To date, 23 surgeries have been completed in those hospitals.

The HSE has completed an international tender for paediatric spinal fusion procedures and three hospitals were successful in their applications.

These hospitals will initiate patient reviews immediately with a view to commencing treatment in October for patients whose families take up the offer of having procedures carried out in overseas hospitals. I know that will not work for everybody but it is another option to try to provide as many avenues as possible for treatment for children who urgently need their surgery.

The HSE is also developing a forecasting model to predict, on a weekly and monthly basis, the number of patients expected to receive surgery by the end of the year. This will assist it further in monitoring the progress made in achieving the target. The overall number of patients waiting for scoliosis procedures has been reducing this year and progress continues in delivering on the HSE's four-month target to the end of 2017 in a planned, safe and sustainable manner. I really hope that once we get through this very difficult backlog, next year we will be able to ensure a sustainable situation whereby we can meet the four-month target in this country without having to outsource any procedures.

Bobby Aylward (Carlow-Kilkenny, Fianna Fail)
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I have raised this matter consistently since 2015. I raised it with the Minister's predecessor, the current Taoiseach, Deputy Varadkar. I have raised it with Deputy Harris on a number of occasions since he took responsibility for the Department of Health. Few cases that come across my desk are more heart wrenching than those relating to the shocking waiting times for children and young people for surgery for scoliosis. We hear the horror stories of children's lungs and hearts being slowly crushed while they wait. We hear about children who can no longer retain their food because their stomachs have been squeezed so badly as a result of their condition. These stories were read into the record of the Dáil in late 2016 by my colleague, Deputy Kelleher, following a meeting I facilitated with the Scoliosis Advocacy Network, which campaigns on behalf of the children involved.

Following the very damning television programme on RTE, which highlighted the long waiting time for young people with scoliosis, the Minister promised earlier this year that a target of a four-month waiting period for treatment of scoliosis would be met by the end of 2017. The former Taoiseach, Deputy Enda Kenny, described the target as an absolute priority. Finally, we began to see meaningful action, although in 2014, 2015 and 2016 the resources were not provided and the scoliosis waiting lists were allowed to grow far too long. However, the problem remains. The number of children at Our Lady's Hospital for Sick Children in Crumlin and Children's University Hospital Temple Street waiting longer than four months for surgery has grown by 17%. In March, there were 134 children waiting for longer than four months for spinal fusion or surgery at the two hospitals. By last month, that number had increased to 145. The figures from the HSE show this.

Simon Harris (Wicklow, Fine Gael)
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I accept the Deputy's very sincere interest. He is right that this is a very important issue. When I became Minister for Health, there was a brand new theatre at Crumlin hospital in which procedures could be performed but that was closed. It is open now. Nurses have been hired and a new consultant orthopaedic surgeon is working there. There were 312 children waiting for such scoliosis procedures on 9 February and 247 on 22 September. We have got to continue to drive that down. We are putting additional resources in place. We have hired the extra surgeon and will hire more surgeons in 2018 in order that we might get that theatre open for at least five days a week. I want to see that happen.

We are going to use every tool available. That is why some children who can have their procedures carried out in the Mater or Cappagh - older children often are being transferred there. Some children have very successfully had their surgery carried out in Stanmore in the UK and have reported positive results. In my time as Minister for Health, I have not seen the HSE make such a proactive and determined effort - as well they should because it is far too high a waiting list - to get this down. They are working extraordinarily hard and we will resource them every step of the way to get there.

Bobby Aylward (Carlow-Kilkenny, Fianna Fail)
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I understand that outsourcing is helping to alleviate the list. Why can we not cater for more of these children by expanding capacity in the Crumlin theatre and opening it for at least five days? My understanding is that it is only open on three days each week at present. Why can we not extend that to five days? We have the surgeons - I think five have been appointed - and we have the nursing staff. Due to their condition, not all of the children can travel abroad although I am glad that some can go abroad to get treatment. Also, referral between the Mater and Crumlin can sometimes break down. I ask the Minister to consider extending the Crumlin theatre's capacity from three days to five. I accept that progress has been made, and the advocacy group accepts that. More must be done.

Simon Harris (Wicklow, Fine Gael)
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I agree. The advocacy group has done Trojan work in highlighting this area of shame in the context of how the situation was allowed to develop. I would like to see the theatre open five days a week. I am assured by the Children's hospital group that this would require more consultants being recruited so, realistically, it will be 2018. Let us work to get there and, in the meantime, let us do everything we can.

The Deputy is right that some children cannot go abroad. I understand there are 68 children and young people whose cases are classified as medically complex. I am informed that, as of 25 September, 61 of these patients require treatment prior to the end of the year. There is capacity for 32 of those procedures to be carried out in Crumlin and there will be a treatment plan put in place for the remaining patients, I am told, within the next two weeks. We will continue to do everything we possibly can in the Department and in the HSE, not just to drive down the list once and for all but to ensure that once we get to an appropriate target, we keep it there. Four months is the clinically appropriate target. We must make sure that we can provide the capacity in this country without ever needing to send children abroad. This year, we have got to do everything we possibly can to get the list down.

Bobby Aylward (Carlow-Kilkenny, Fianna Fail)
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Can the Minister extend the number of days on which the theatre is open each week from three to five?

Simon Harris (Wicklow, Fine Gael)
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If we can get more consultant surgeons. That is a priority but it is likely to be 2018.