David Cullinane (Waterford, Sinn Fein)
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4. To ask the Minister for Health his plans to achieve a maximum of four months waiting time for paediatric spinal surgeries; and if he will make a statement on the matter. [19774/24]

David Cullinane (Waterford, Sinn Fein)
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This question relates to spinal surgeries for children with scoliosis and spina bifida. The Minister will be aware that over the past number of months there has been a number of high-profile reports of children and their families having to take the media. Some of those children have been waiting since as far back as 2020 for their spinal surgeries to be done. The families are pleading for help and looking for Children's Health Ireland, CHI, to deliver the care their child needs. What more can be done to ensure that the promise that was made that no child would have to wait longer than four months is delivered?

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy for the question. I acknowledge that the waiting lists for these children are simply too long and that while more capacity is being is being added and more surgeries are being done, there are a number of children for whom the wait is simply unacceptable.

In 2022, I asked Children's Health Ireland to come up with a comprehensive plan that would mean that of the children who are scheduled and actively waiting for surgery, no child would be waiting more than four months. CHI devised a plan and I funded it to the tune of €19 million. The assurance I was given was that by the end of 2022, no child would be waiting more than four months. Unfortunately, that plan clearly did not work.

I intervened again in 2023. I went and I met privately with the surgeons and asked them what they believed needed to be done. What they said ultimately was required was to establish a dedicated spinal service. They referenced places such as Stockholm where the services are ring-fenced, including the theatres, specialist nurses and anaesthetists, specialist wards, intensive care units, high-dependency units, health and social care professionals and specialist ward nurses. That is exactly what we are transitioning to.

I have allocated more funding this year. Very significant capacity is in place now. We funded a fifth operating theatre and a second MRI facility. More than 200 healthcare professionals had been hired by CHI under the €19 million.

I had a meeting only yesterday with Dr. David Moore, who is heading up the service and is one of the spinal surgeons, with my Secretary General, the regional executive officer, the chief executive of CHI and the chief executive of the HSE to make it clear that everything that can conceivably be done to accelerate this dedicated spinal unit must be done. I made it clear that the view, not only of the Government but all of us in the Oireachtas, is that we must get to a point where no child waits more than four months.

David Cullinane (Waterford, Sinn Fein)
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Despite all of the talk that comes from Government and the Minister regarding record investment, record staff, record capacity and all of that, we have children who are waiting. Last week, I raised with the Taoiseach the case of Liam Dennehy, who has been left waiting more than five months for his surgery. Unfortunately, his spinal curvature is going in the wrong direction. I also raised, on Tuesday, the case of Paddy Murphy, a 14-year-old who has been waiting for his surgery since 2020. There are many cases like that. Unfortunately, we are failing those children.

The Government made the promise, starting with the Taoiseach, then as Minister for Health, and continuing with the current Minister that no child would have to wait longer than four months.

Deputy McDonald asked the Taoiseach a number of weeks ago when the treatment abroad option would be resumed and what that would look like. We still have not received any clarity. The Deputy also asked about the Government funding a second opinion for families who are concerned about the clinical recommendations they are being given. Given that it is their child and given the length of time they are waiting, all of these options should be looked at. Can the Minister answer those specific questions An Teachta McDonald asked and that we still have not had a response to?

Stephen Donnelly (Wicklow, Fianna Fail)
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I can. We had a useful session yesterday. I might organise a briefing for members of the health committee who are interested as well. There is a lot of important work under way.

As to the treatment abroad scheme or whatever it might be, we have been very clear with CHI in saying if it can find what our surgeons say is clinically appropriate care for the children, be that in Boston's hospital or the UK, Germany where it was done before, Stockholm or indeed anywhere, this Government will fund it. CHI has been given a very clear direction on that. It does not have to comply with the treatment abroad scheme, which is an EU scheme. If we can find this treatment in the United States, Canada or wherever it may be, CHI has been told that as long as it is clinically appropriate for these children the State will fund it, we will fund their families going over and we will support the whole thing.

I will respond to the Deputy's second point when I come back in.

David Cullinane (Waterford, Sinn Fein)
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The problem is that for many parents and many children that is not happening. A number of weeks ago I raised the case of Aiveen , a young child with early-onset scoliosis. Her family crowdfunded for her to go to America to get specialist treatment. She got that and is now doing very well. She certainly did not get the support from the HSE. Her family had to depend on the public coming in behind that campaign and her getting the support. I have mentioned two cases but there are hundreds of children waiting for scoliosis treatment, with many of them waiting longer than the four-month time period. There needs to be more urgency. The families who may be listening will be thinking it is all very well for the Minister to say he will do everything possible, because if it is not happening for those families then that is their lived reality. We have to make it happen for them. We also have to look at what additional capacity is needed domestically as well.

I asked about the second opinion. There is a lack of trust in Children's Health Ireland. It gives me no pleasure to say that, but it is a reality. The Minister had to send in an audit team to look at money that was spent to ensure it went to the right places. We have a number of reviews that are ongoing at the moment. For all those reasons the call by the parents for a second opinion to be funded by the State is a reasonable one and I am asking whether it is something he will support.

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not disagree with any of that. The families are angry and they have every right to be angry. There is no defending what has happened. We have to fix it and fix it permanently. That is what this dedicated spinal unit is going to do. The team in CHI are meeting other international providers this week. I have told them that as far as I am concerned they have full authority to go and secure this on behalf of the children.

On the second opinion, I will get a more detailed note but I understand the families who were within the scope of the Mr. Nayagam review, whether they got actively involved or not, have been offered a second review and a small number have taken it. I point out the feedback from the CHI surgeons is that while we can secure a second opinion from Great Ormond Street or wherever we want, they ask what happens then. It is still the same surgeons here trying to do the work. We are, therefore, expanding the number of surgeons and the capacity they have. I have also instructed CHI and the HSE to completely ring-fence all theatres, MRI, ICU and ward beds required in that our own surgical teams can be fully utilised to treat as many children as possible.