Colm Burke (Cork North-Central, Fine Gael)
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I am raising this issue because of a report published in the last week, namely, the National Paediatric Mortality Register Annual Report 2025. It sets out the concerns about the lack of a centralised, universalised reporting system for reporting and analysing child deaths. This is hindering progress in addressing the root causes. What steps is the Minister of State taking to address this issue? The report covers the audit from 1 January 2019 to 31 December 2023. It shows that deaths of children are higher in some areas, aspects and age groups in Ireland compared to other European countries. For instance, there has been no significant decline in mortality in the age groups of those aged from ten to 14 and 15 to 18. In fact, rates in Ireland from 2007 to 2023 in the age groups one to four and five to nine show there has been no decrease. In the age group of those aged ten to 14 there has been no decrease. In the age group of those aged 15 to 18, however, there has been an increase. This is the concern that the report shows. It is interesting to see the figures in that the number of deaths recorded for those aged under one year of age was 363. For those aged one to 14, the figure was 145, while for those aged 15 to 18, it was 104.

The major aspect of this report shows that there is no centralised system of any description for reporting. There also seems to be quite a delay in the reporting of the deaths. As a result, the analysis is not occurring. The report clearly indicated a need for a proper data collection system, for an analysis of infection-related deaths, that is, in children, and for a review of data relating to circumstances of potential suicide. This is especially the case in the age group from 15 to 18. In the case of sudden infant death syndrome, SIDS, there is a need for accurate and timely information regarding the circumstances of those deaths.

There is another interesting issue. My understanding is that when a post mortem is requested in the case of the death of a child receiving treatment in a hospital, the post mortem report goes to the coroner, but there is no direct feedback to the doctors who were treating the child, and if feedback is given, it happens at a considerably later stage. It can take anything up to two years for an inquest to be held, and therefore the post mortem report is not made available. The doctors concerned in treating that child may have moved on to another hospital or indeed to another jurisdiction. That is something that must also be reviewed.

The report is a comprehensive one of more than 150 pages. It deals with all of the aspects relating to infant deaths and child deaths. The Department now needs to take on board the recommendations in the report and the need for a centralised system. I ask that this request would be taken on board at the earliest possible date.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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The Minister for Health extends her deepest sympathies to all parents and families who have experienced the tragic death of a child. The most recent data on child deaths comes from the second report of the national paediatric mortality register conducted by the HSE's National Office of Clinical Audit, NOCA, which is built on early data collection work. While the report makes for very difficult reading, it provides important information which can be used to improve our services and to prevent potential avoidable deaths in children and young people.

The report notes that sudden infant death syndrome, SIDS, was the leading cause of the post neonatal deaths registered during 2022 and 2023, accounting for 37% of deaths. The rate of SIDS increased from 0.24 in 2019 to 2021 to 0.35 in 2022 to 2023. The report advises that the reason for this increase is unclear but that the writers of the report will closely monitor 2024 data to identify potential trends. At 2.2 per 1,000 live births, the provisional infant mortality rate in Ireland for the period 2022 to 2023 is slightly higher than in 2019 to 2021, when it was 3.1, and is now the same as the EU average.

The Minister acknowledges the finding that mortality in children aged from one to four and age five to nine has continued to decrease but is committed to reducing the rate in all age categories. In particular, the Minister welcomes the recommendation that the deaths from infection and sepsis will be a focus and a special feature of the next report. Continued data collection provides important additional information and evidence that will help to reduce further avoidable deaths.

The Ombudsman for Children's Office, OCO, started an engagement process in 2024 to consult the key stakeholders to explore the need for a statutory national child death review mechanism in Ireland. The aim of the consultation process by the OCO is to increase the awareness and understanding of the current practice across statutory services when a child dies of non-natural causes. The OCO engaged directly with the Department on this matter and identified other key stakeholders such as the HSE, Tusla, the National Office of Clinical Audit, the Department of Education, the Department of Children, Equality, Disability, Integration and Youth, HIQA, and the Coroner Service.

The Department of Health is committed to reducing the rate of avoidable deaths in children across all age groups and has made considerable investment in this area in recent years. Since the national maternity strategy was launched in 2016, more than €80 million has been invested in new development funding across maternity and gynaecological services. This investment has also brought more than 530 additional full-time staff into maternity services across all staff categories.

In 2023, funding was allocated to support the ongoing strategy development of the national paediatric service. This facilitated the recruitment of an additional 56.7 whole-time-equivalent, WTE, clinical posts. This also included 26.5 WTEs for gynaecological services in CHI to enhance the service in preparation for the establishment of the neonatal intensive care unit, NICU, in the new children's hospital. These posts include consultants, nurses, practitioners, staff nurses and other clinical staff. The Department of Health continues to engage with the Ombudsman for Children, the HSE, the NOCA and other stakeholders this matter.

Colm Burke (Cork North-Central, Fine Gael)
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I thank the Minister of State for her reply. The recommendations are quite clear. Recommendation 1 is "The National Office of Clinical Audit (NOCA) must urgently progress the implementation of an electronic data collection system in order to allow for the timely submission of CYP mortality data to the NPMR". It is a clear recommendation. Recommendation 2 is that there would be a "detailed analysis of infection-related deaths". Recommendation 3 is that "NOCA should contribute to the evidence base required to inform policy around suicide prevention by reviewing data relating to the circumstances of potential suicide deaths". Recommendation 4 is that, "Detailed, accurate, and timely information regarding the circumstances of SIDS deaths is required to make further improvements in the prevention of these deaths."

There are four clear recommendations. When is the Department going to implement those recommendations in full? Are we talking about 12 months, two years or three years? There are clear recommendations that were set out by a very expert group. It is a matter for the HSE and the Department of Health to get together and implement the terms of these recommendations.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Deputy. I offer my deepest sympathies and those of the Minister for Health to all parents and families who have experienced the tragic death of a child. Information on child deaths comes primarily from the national paediatric mortality register conducted by the HSE's National Office of Clinical Audit. The reporting provides vital information, which is used to improve our services and to prevent avoidable deaths.

The Department of Health is committed to reducing deaths in children across all age groups and has made considerable investment in this area. Specifically, the Department continues to engage with the Ombudsman for Children, the HSE, NOCA and other stakeholders to explore the need for a statutory child death review mechanism in Ireland. The aim of this consultation process by the OCO is to increase the awareness and understanding of the current practices in statutory services when a child dies from non-natural causes.

I thank Deputy Burke for bringing up this matter. He spoke about the recommendations, in particular the four he outlined. He is looking for a timeframe. I will come back to him with what is going to happen. I will definitely look into this and come back to the Deputy with a timescale as soon as I can.

Colm Burke (Cork North-Central, Fine Gael)
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I thank the Minister of State.