Christopher O'Sullivan (Cork South West, Fianna Fail)
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This matter relates to children with scoliosis, specifically in the context of the length of time they have to wait for surgery. I want to raise the issue of Anna Russell, who is 13 years old and is from Glengarriff in west Cork. She is truly a great kid. If the Minister of State ever has the pleasure of meeting her, he will see her charm. She is absolutely charming and I am sure the Minister of State will be taken aback by her incredible personality. She is in first year in secondary school in Bantry.

Anna has scoliosis. She was diagnosed with it three years ago. The curvature of her spine has now reached 60°. This is obviously causing discomfort and has a massive impact on her day-to-day life. Her surgeon said she needed surgery by the summer of 2023. We are now into the summer of 2024. It is estimated that the curvature will increase by between 15% to 20% for every six months of her life. As we can gather, surgery is urgently needed.

Anna is just one of many children who are going through this process. She had her pre-operative MRI in November. She has had a pre-operative assessment. To give the Minister of State a flavour of what these kids are going through, on two occasions as she was heading to Crumlin from Glengarriff for pre-operative healthcare, she was sent home halfway through the journey. In other words, the operation could not go ahead. The distance from Glengarriff to Dublin is in the region of four and a half to five hours. One can imagine the heartbreak when a young girl who is full of life, great personality and character is halfway to an assessment and is then sent back.

Something needs to happen as a matter of urgency. Anna has no idea when her surgery will take place. She does not know whether it will be in one month or one year. In the meantime, she and her family are in complete limbo. Anna is uncertain, worried and uncomfortable. She has to undergo a bus journey from Glengarriff to Bantry on a daily basis. One can imagine the discomfort she is going through and how tired she is having to deal with this. Her mum is concerned. She is a terrific mother who wants the very best for her young child. I know the Minister of State cannot solve the issue of waiting lists for scoliosis with the stroke of a pen, but I beg him to bring Anna's case to the Department of Health and Minister for Health and ensure that her case is heard and her surgery happens as soon as possible.

Colm Burke (Cork North Central, Fine Gael)
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The Deputy has given a very good and detailed explanation of the challenges Anna and her family face. I fully understand the situation because I have also come across constituents facing similar challenges.

I am here on behalf of the Minister for Health. I thank the Deputy for raising the matter of children on waiting lists for scoliosis surgery. The Minister acknowledges that waiting lists for scoliosis services are unacceptably long. He is acutely conscious of the burden this places on patients and their families. For this reason, the Minister for Health committed €19 million to scoliosis and spina bifida services to tackle these lists by creating additional capacity. The goal is clear; it is to reduce the waiting time for anyone for whom surgery is clinically appropriate to no more than four months.

To date, over 200 additional healthcare professionals have been recruited across Temple Street, Crumlin and Cappagh hospitals, including nurses, consultant doctors, anaesthesiologists and radiographers. This investment also funded a fifth theatre in Temple Street, an additional MRI in Crumlin and additional beds. The impact of this investment can already be seen. There was a significant increase in the number of paediatric spinal procedures carried out in 2022 and 2023. In 2022, 509 spinal procedures were carried out, and in 2023, 464 spinal procedures were carried out. This represents increases of 34% and 22%, respectively, compared to 2019.

Despite undertaking record numbers of procedures, corresponding reductions in the waiting list have been offset by significant increases in demand. As Deputy O'Sullivan said, the patient to whom he referred was identified over three years ago. The demand for referrals increased substantially. There was a 30% increase in additions to the spinal fusion surgery list in 2022 compared with 2018, and a 42% increase in 2023 compared with 2018.

At the end of December 2023, there were 231 children on the waiting for spinal procedures, excluding suspensions, which is a 5% reduction compared to the end of 2022. In 2023, there was a 13% reduction in the number of patients waiting longer than four months for surgery. Over 140 spinal procedures have been done so far this year. While waiting lists remain far too long, it is fair to acknowledge that there is an increase in the number of patients being treated, and there is progress towards the goal of having no child waiting more than four months for surgery, where clinically appropriate.

At the Minister's request, a dedicated paediatric spinal surgery management unit has been established in Children’s Health Ireland, which is focusing on delivering further improvements to the waiting lists.

The Minister recently allocated a further €1.34 million to enhance spinal services in CHI following a request from the clinical lead of the management unit. This includes additional clinical staff, additional Saturday outpatient clinics to reduce outpatient waiting lists, and additional capacity for MRI scans under general anaesthetic.

A dedicated stakeholder paediatric spinal task force has been convened with an independent chair. This task force will include all stakeholders, including patient representatives and clinicians. The Minister met some advocacy groups to discuss the terms of reference for the task force. The Minister for Health has appointed Mark Connaughton, SC, as chair, and Mr. Connaughton has since invited all advocacy groups to meet him.

Christopher O'Sullivan (Cork South West, Fianna Fail)
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I acknowledge the increased expenditure of €19 million, the 200 additional healthcare professionals and the reductions in waiting lists of 5% and 13%, but there is a statistic that is concerning, namely that although there were 509 procedures in 2022, there were fewer in 2023. Therefore, something has gone awry. I appreciate that the Minister is not here and that the Minister of State has inherited a bit of a mess, but that mess needs to be sorted because people like Anna Russell are suffering. I am sure the surgeon, for whom I cannot speak today and who operates out of Crumlin, would state the whole thing is a bit of a mess.

Despite the investment, which is of course welcome, and the recruitment of additional staff, children like Anna Russell, an incredibly charming young girl, are going through unnecessary pain. Their conditions are getting worse and their curvature is increasing. The more it increases, the more pain poor Anna will go through.

I acknowledge that much work has been done but the Department needs to acknowledge that it is still not good enough and that young people should not be waiting as long as they are, not just for surgery but even to get a date for surgery. Anna and her mum, Marion, have no idea whether the surgery will happen in a month, a year or two years. They should at least have a date.

Colm Burke (Cork North Central, Fine Gael)
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The Deputy has made a very strong case in respect of his constituent. It is important that I take on board what he has said and that we continue to try to improve the services. The Minister for Health is assuring children and their families that the Government will continue to invest significant funding to help clinicians to reduce the time for which children must wait for important hospital appointments and procedures. Significant additional investment has been committed to tackle the waiting lists for spinal services by creating additional capacity.

A dedicated paediatric spinal surgery management unit has been established and it is driving improvements to the waiting lists. A dedicated stakeholder paediatric spinal task force has been convened to collaboratively address concerns raised by families and advocacy groups. We are making progress on the waiting lists for spinal surgery despite the significant increase in demand and referrals by comparison with previous years.

At the end of 2023, there had been a 13% reduction. I fully accept that we should be doing better. The reduction pertains to the number waiting over four months for spinal procedures by comparison with the number at the end of 2022.

The Minister has asked the HSE and CHI to explore all options to increase capacity for this vital service so as to reduce the waiting times and ensure improved access for patients. The Minister is committed to ensuring every child is seen within four months, as clinically appropriate. An entire team is needed to carry out the surgery in question. It is very challenging and it is important to have the best expertise in doing the work. Unfortunately, if a component is missing at any stage, a procedure cannot go ahead. The hospitals are working very hard to reduce the waiting list further.