James Lawless (Kildare North, Fianna Fail)
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63. To ask the Minister for Health the additional support that is being provided for National Orthopaedic Hospital Cappagh children's ward in 2022; and if he will make a statement on the matter. [7903/22]

James Lawless (Kildare North, Fianna Fail)
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My question is in regard to Cappagh hospital. The Minister and I have discussed this issue previously so I know that he is familiar with the situation with regard to children with spina bifida and the waiting lists, in particular at Cappagh hospital.

I ask the Minister to tell the House what is being done in that regard.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy for raising the issue. The National Orthopaedic Hospital Cappagh is Ireland's major centre for elective orthopaedic surgery and through the wonderful Cappagh Kids initiative, the national orthopaedic hospital provides additional capacity for the treatment of some of the more routine paediatric orthopaedic patients, including some routine scoliosis procedures. Using the capacity provided by Cappagh first and foremost means children are treated there, but it also means that Children's Health Ireland, CHI, is freeing up space so that the more complex orthopaedic procedures, including spinal fusion, can be carried out centrally at the CHI sites. Total funding of €1.65 million was provided to Cappagh last year. Funding for this year will be encompassed within the waiting list action plan. Cappagh estimates it can do approximately 640 non-complex surgeries and can treat another 340 inpatient and day cases. There is an awful lot of opportunity there.

Additional theatre capacity in Cappagh commenced in April last year for day case surgery. CHI has advised that this should result in the positive impact of a reduction in the waiting times for general paediatric orthopaedics which, quite frankly, are too long. This year, CHI is planning to undertake a range of inpatient, day case and outpatient orthopaedic appointments in Cappagh. Last week, I convened a meeting with the clinical teams from Crumlin, Temple Street and Cappagh, along with senior management from the three hospitals and the HSE. The purpose of the meeting was to discuss this draft paediatric orthopaedic waiting list plan to make sure it is sufficiently ambitious and that it does what we all need it to do, which is to provide care to these children who have been waiting for too long.

James Lawless (Kildare North, Fianna Fail)
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I thank the Minister for his reply. I am aware that some funding has been channelled towards Cappagh and CHI in recent times. The families of children in this situation have been in touch with me, as I am sure they have been with the Minister and many others in this House. Their number one priority is to change the situation being faced by children who are waiting in some cases up to four years for surgery. The condition is sometimes by then inoperable because the child's condition has worsened to such an extent. The parents want this issue tackled. The view, certainly among the families, is that Cappagh is the place where these surgeries should be performed. It is the place that needs the funding and attention. I know there has been talk about money going to CHI. I am not sure whether that would filter through from CHI to Cappagh or how that would work in practice.

The other point that has been made to me is that there is sometimes competition for places in an operating surgery or theatre. Children coming in with complex needs, including spina bifida, scoliosis and other conditions, can find, particularly in an elective context, that another child has an accident or something happens in a game of rugby or whatever else and that child is rushed in. An operation on a child with spina bifida could take six, seven or eight hours while another surgery could be performed in one hour. Eight children could be seen in the same time it takes to treat one child with spina bifida and the children with spina bifida are knocked out again and again. They do not necessarily go to the back of the queue but they certainly do not get seen. The view of the families is that they need a dedicated facility to perform these procedures and operations. Can that be done in Cappagh? Does this money allow that? Perhaps the Minister would clarify that point for the House.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. The solution for the children is to use all the hospitals. There is no one hospital. Not one of Cappagh, Crumlin and Temple Street can do this on its own. That is why I convened a meeting of all three hospitals last week. There is also work we can do with Blackrock Clinic. We had a meeting earlier today at which the Beacon was also referenced. The three main hospitals are Crumlin, Temple Street and Cappagh, which is already doing phenomenal work. I was out at Cappagh Kids on Friday and saw the facility, which is fantastic. As the Deputy said, the great advantage of Cappagh is that it is an elective hospital.

What is happening in Crumlin and Temple Street, for example? In one of them, there is a lot of urgent neurosurgery required. There is a lot of urgent heart surgery required in the other. The surgeons and children must get emergency access to these theatres and the orthopaedics can get bumped. I am determined that all these children will get the care they need. It is a multi-hospital solution.

James Lawless (Kildare North, Fianna Fail)
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Another point that has been made to me, and I think the Minister was alluding to it, relates to wraparound services. For example, one child in my constituency has had an operation but needs to see a urologist next. There are a number of other supporting services that are desperately required to address that child's ongoing needs. That has been a difficulty.

I am trying to understand how the constituent parts of the hospital system, including Cappagh, the CHI, the Beacon, as the Minister mentioned, and other places, can come together to provide that holistic care in a way that tackles the waiting lists and allows children to be seen and accommodated without having to wait four years or until a time their condition is inoperable. We must also provide the follow-on services that are required post operation so they can be seen in a timely fashion and in a way they are not competing with children with less complex needs, which is the case at times now.

There was talk in the Chamber last week of €5 million funding for Cappagh and money that has gone to CHI. There is a little bit of complexity or confusion about exactly what funding has gone where. It would be of great assistance to the families and the House if the Minister would clarify that. What funding is flowing to Cappagh, CHI and elsewhere? What is that money ring-fenced for? How will that assist the children in the short term and the long term?

Stephen Donnelly (Wicklow, Fianna Fail)
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The Deputy is right about the funding. There is crossover. The paediatric orthopaedic teams who work in Cappagh do a lot of work in Temple Street. There has been less crossover with Crumlin but the Crumlin team is now working with Cappagh as well. There is going to be a lot of interaction in that regard. In terms of funding, there is money going to CHI, be that to Crumlin or Temple Street. That work is ultimately happening in Cappagh. There is additional funding going to Cappagh to allow it to do work.

The Deputy also asked whether the more complex work can be done in Cappagh. At the moment, the surgical teams have said the most complex work needs to be done in Crumlin and Temple Street. One of the reasons for that is that high-dependency units are required. One needs a lot behind that work because the cases are very complex. However, I spent a lot of time at Cappagh on Friday. Its staff have big ambitions. They have submitted a proposal, for example, that I think is really interesting for significantly more high-dependency unit beds, which could help the children but also help with adult orthopaedics as well. What I would like to see, with additional funding, is complex work also being done at Cappagh. That is also Cappagh's ambition.