Duncan Smith (Dublin Fingal, Labour)
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59. To ask the Minister for Health the detailed breakdown of child and adolescent orthopaedic and related surgeries waiting lists; his plans to tackle those waiting lists; and if he will make a statement on the matter. [7729/22]

Duncan Smith (Dublin Fingal, Labour)
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Continuing on the theme of waiting lists, my question relates to the waiting lists for child and adolescent orthopaedic surgeries. These are very complex surgeries which require complex follow-on care and recovery pathways. It is not a case of scheduling X amount of hours in a theatre to get a surgery through. The issue is more complex than that. I want to hear the Minister's plan for the treatment of these young people. With each passing week, month and year, their conditions deteriorate and they become more complex to eventually resolve.

Stephen Donnelly (Wicklow, Fianna Fail)
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This is one of the most pressing areas of the waiting lists. Children are waiting for orthopaedic surgery, whether spinal surgery or surgery for scoliosis, spina bifida, hip deformities or a range of other conditions. Some are being treated quickly, which is a great testament to our clinicians and health service, but far too many are having to wait for far too long. It is not acceptable now and has not been acceptable for years. Significant progress was being made in the treatment of scoliosis and spina bifida in 2019. The numbers waiting for far too long were coming down.

Obviously, the last two years made that very difficult. Last week I convened a meeting of the three hospitals involved, namely, Crumlin, Temple Street and Cappagh. I met the surgeons, hospital managers and the director of nursing. Some time ago I asked the HSE to put together a comprehensive solution for these children and their families. That is what we met to discuss last week. I then visited Cappagh on Friday, including Cappagh Kids. The hospital has really ambitious, interesting proposals for children and adolescent, and adult services in the from of high-dependency units, more beds and so forth. We have what I think is a very ambitious but very good plan in place. We are putting some final details on that but ultimately we need to ensure the capacity is in mainly Crumlin, Temple Street and Cappagh. Other hospitals can help but they are the three main places that will make sure these children get the care they need very quickly.

Duncan Smith (Dublin Fingal, Labour)
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I thank the Minister. I am glad there is an ambitious plan and a good plan and that he has met with the three main hospitals in the past week. However, what was reported at the weekend in the Business Postgives all these questions a different complexion. Obviously, all these questions were submitted in advance of that. I heard the Minister of State, Deputy Butler, and indeed the Minister of State, Deputy Rabbitte on the radio. They gave very credible accounts as to how they come up with their budgets and the work that would go into it, which I believe. However, does the Minister now have faith that when ambitious plans for this area or any other in health are put together and he provides the money, it will actually be delivered and will go into the HDUs and the staffing levels? This is not a "Gotcha" question. It is a very serious question because whatever the merits of how that article came to be, namely a secret recording and all the rest which is not great, the fact is it was presented to us. It poses very serious questions about whether what the Minister says is delivered on the ground by the HSE through the Department.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. What I asked for from the HSE was an ambitious plan that would get these children the care they need as quickly as possible. I am not interested in solving it over a five-year period; we have got to solve it now. We have paediatric orthopaedic surgeons who do not have the operating theatre time they need. We have operating theatres that are open between 9 p.m. and 5 p.m., Monday to Friday, but not earlier or later and not on Saturdays or Sundays. There is much opportunity there. The HSE worked with Children's Health Ireland, CHI, and with Cappagh and have come back to me with a very ambitious plan. I will shortly be able to share the details. Will they achieve everything set out in the plan, even if it is fully-funded? They are going to try their very best but in a conversation I am having with their surgeons, they are saying that with healthcare, especially at the moment, it is very hard to give definitive guarantees on all of this. Emergency cases come in, theatres get used up, and maybe the neurosurgeons need the theatre that was meant to have a full list of paediatric orthopaedics that day. As such, there is a genuine nervousness and caution when CHI is giving me these figures. I would love all of us to recognise that what I am doing and what the Minister of State, Deputy Butler, is doing is we are setting very ambitious targets and they are not always met by nature of the fact we are asking the system to go beyond what it has ever done before.

Duncan Smith (Dublin Fingal, Labour)
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On the targets, I am aware the Minister probably cannot give full details. What I am getting from his response is we would be looking at theatres being open at off-peak hours and maybe on Saturdays and Sundays. Is that something he could confirm to the House this evening as part of this ambitious plan? That would be an encouraging sign that there is going to be real energy put towards making a dent in this. Nobody in this House believes something as serious and with such a depth of waiting lists will be resolved in a very short period. Second, regarding the follow-on care such as physiotherapy and all the related multidisciplinary care, does this ambitious plan deal with that level of following the surgeries? If so, is the Minister confident the staffing levels will be in place for the multidisciplinary teams in order that they will be able to provide that follow-up care?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, the plan is for end-to-end care. One of the surgeons at the meeting last week made a related point. He said we are not funding individual surgeries in this regard; we are funding care for children. He said several of these children may have to go in for multiple surgeries and they may need multiple surgeries this year. Thus, the targets are not around individual operations. What we are looking at is child by child, that is, are we putting a plan in place that can get this child, as the Deputy said, the pre-operation support, then the surgical help and then the post-operation recovery as well.

Duncan Smith (Dublin Fingal, Labour)
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Will that include the off-peak hours for the theatres?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, absolutely. It is something we have discussed - both Monday to Friday and opening earlier and later. It is something that happens in the adult private world. The operating theatres run longer as do the diagnostic suites. The operating theatres are open on Saturdays and sometimes Sundays. In fact, the HSE sometimes uses the private facilities sometimes on a Saturday. It is a "Yes", and not just in paediatric orthopaedic but right across the board.