Alan Dillon (Mayo, Fine Gael)
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I thank the Ceann Comhairle for selecting this important Topical Issue matter, which relates to children with the life-altering condition of scoliosis. This continues to be a very significant issue, despite promises made over a span of six years.

In 2017, the Department of Health made a commitment that children with scoliosis would not have to wait longer than four months for a crucial surgery that can transform their lives. However, it has now been many years since the initial promise was made in these Houses to reduce these agonising wait times.

In my constituency of Mayo, several children are still awaiting surgery well beyond the promised four-month period and I have spoken to many of these parents and children. One such case is a 13-year-old, Leah Heenan from Toormakeady, and I know that Leah and her family are tuned in to the Oireachtas tonight to listen to this debate. Leah has been waiting anxiously for the past three years for spinal fusion surgery that would give her the chance to reclaim her life. Leah was diagnosed with scoliosis at the age of ten and since then, she and her parents have made the arduous journey to Dublin on numerous times each year. Initially, she was given a body brace but she has outgrown that now. The paediatric consultant and orthopaedic surgeon in Dublin assured her that the surgery will take place once a bed was available. Unfortunately, to date no bed has been found and her surgeon has now stated that he is too busy, requiring her to be referred to another specialist.

This means that the family must endure the lengthy process of pre-operative checks once again, which is both time-consuming and physically draining, considering the distance between Mayo and Dublin.

Meanwhile, Leah is on the verge of transitioning from primary school to secondary school, moving from her village to a nearby town for her education. Her parents had hoped that her surgery would be complete before this transition but the chances of that happening now seem slim. Indeed, the family themselves are calling the hospital on a daily basis, desperately seeking answers on this important matter.

Unfortunately, most of the time, their calls go unanswered due to the immense pressures faced by these medical professionals and their staff. The HSE has informed Leah's family that it is unable to provide a scheduled date or timeframe for her surgery and they have been advised that if her medical condition worsens while waiting, they should inform her consultant.

However, Leah cannot even secure an appointment to be fitted with a more suitable body brace as her spinal deformity continues to deteriorate.

Just a month ago, a scathing and devastating report from the Ombudsman for Children highlighted the case of a 17-year-old, Ivy, who endured five-year wait for similar surgery. The report recommended that Children's Health Ireland, CHI, conduct an audit of waiting lists for children with scoliosis care and implement reform such as allowing patient care and reviews to be initiated by parents, their families, GPs and others involved in their care. We must now learn from Ivy's story to ensure that children like Leah in Tooramakeady receive the help they desperately need.

The Minister of State has probably received a response from the Department of Health and I thank him for being here in the Chamber tonight. Can he provide some clarity about when children like Leah will no longer have to endure waiting periods exceeding three years for this life-changing surgery? It is crucial that we take immediate action to address the pressing issues and alleviate the suffering of these vulnerable children.

James Browne (Wexford, Fianna Fail)
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I thank the Deputy for raising this very important matter around the ongoing delays in scoliosis surgeries. I welcome the opportunity to address the House on this extremely important issue. The Government sincerely regrets that children like Leah can experience long waiting times for scoliosis treatment and it remains conscious of the burden that this places on them and their families.

Last year the Minister, Deputy Stephen Donnelly, approved an ambitious plan from Children’s Health Ireland to reduce the number of children waiting for spinal orthopaedic procedures, whether scoliosis or spina bifida, by the year end, with significant current and capital funding committed to implement the plan. This funding is providing additional theatre access at Temple Street and Crumlin, diagnostic MRI capacity, and enabling further activity and paediatric theatre lists at Cappagh hospital, also known as Cappagh Kids.

The additional activity is targeted at reducing the number of children waiting long periods for orthopaedic procedures, including scoliosis and spina bifida. We did make progress. In 2022, 47% more scoliosis procedures were carried out than in 2021. If we compare to pre-pandemic levels, this represents a 34% increase.

Despite undertaking a record number of spinal procedures in 2022, corresponding reductions in the waiting list were offset by significant increases in demand and referrals compared to previous years, with a 30% increase in additions to the spinal surgery list compared with 2021. Whilst the growth in referrals is stabilising in 2023, this latent Covid-19 demand has resulted in increased outpatient activity.

The HSE and CHI have developed a plan for 2023 to continue and build on the work done in 2022. Additional funding supported the recruitment of additional staff to enable the expansion of paediatric orthopaedic services. The posts related to the multidisciplinary team: at diagnosis, pre-assessment, during surgery in-theatre, and post operatively. The posts included a number of grades and specialties, including registrars, consultants, radiographers, clinical nurse managers, staff nurses, physiotherapists, occupational therapists, and associated administrative posts. Recruitment and retention of staff remain priorities to ensure reductions in waiting lists for scoliosis treatment.

In 2023 to the end of June, CHI and the National Orthopaedic Hospital Cappagh have completed 219 spinal procedures. The figure includes 101 spinal fusion surgeries, as well as 118 other spinal procedures, and represents 89% of the projected activity to the end of June, and 46% of the targeted activity for the full year 2023. To the end of June, Cappagh has completed 311 non-complex orthopaedic surgeries and 13 surgeries for spina bifida patients transferred from CHI. These figures respectively represent 52% and 33% of targeted activity for the full year 2023.

All patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multidisciplinary team. The plan of care which is implemented for each patient is tailored to best meet the patient’s clinical requirements. The complexity of a child’s total medical condition dictates the level of planning and pre-operative work and time needed.

This Government is committed to building on progress achieved to date to reduce waiting times for children like Leah awaiting scoliosis treatment.

Alan Dillon (Mayo, Fine Gael)
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Gabhaim buíochas leis an Aire Stáit. I understand and appreciate his detailed response. However, the reality remains that despite the additional funding allocation last year, children and patients who require scoliosis or other spinal interventions are still enduring wait times exceeding four months and in some cases they have been waiting three or four years. This situation is utterly unacceptable and tonight we need to get that message back to the Minister, Deputy Donnelly.

The heartbreak, in truth, is that these young children and teenagers, despite the promises, continue to suffer in pain. As a father, one would not wish that on any other parents' children. Many wake up in the middle of the night and experience excruciating discomfort, while being unable to engage in activities which other children of their ages can enjoy.

It is very important that the funding, recruitment and that the specialists are put in place. Leah and countless others in Mayo and across the country are in desperate need of this surgery. Their lives are, effectively, put on hold as they anxiously wait for an operation that has the potential to transform their lives. The urgency of their situation cannot be overstated. I reiterate it is vital that we address this issue promptly to ensure the children and patients receive the necessary treatment without any further delays, that both their well-being and quality of life are at the centre of this matter and that we prioritise their urgent medical needs in the weeks and months ahead.

James Browne (Wexford, Fianna Fail)
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I again thank the Deputy for raising the ongoing issues with regard to delays in scoliosis surgeries and, in particular, for his mentioning of the very difficult situation which Leah is experiencing. As has been acknowledged, many patients, including children, who are waiting for scoliosis treatment are waiting for an unacceptably long time. While significant work continues to positively impact on waiting times and in improved pathways to elective care, acute hospitals are still impacted by pent-up demand that arose as a result of the pandemic.

On 7 March the Minister, Deputy Donnelly, published the 2023 Waiting List Action Plan, which is the next stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists and build on the foundational work done through the short-term waiting list action plan between September and December 2021. This was followed by the first full year of the waiting list action plan for 2022, both having reversed the annual trend of rising waiting lists. The Government continues to invest funding to reduce the amount of time people are waiting for important hospital appointments and procedures.

In 2022, €350 million was allocated to the HSE and the NTPF to provide additional public and private activity to further stabilise and reduce scheduled care waiting and times in tandem with bringing forward much-needed longer term reforms. For 2023, this investment has increased to €363 million. Scoliosis and spina bifida are included as one of the priority areas for this funding. Through investment and reform, the Government is working to sustainably reduce and reform hospital waiting lists and waiting times that will deliver improved access to care for patients throughout the State.