David Cullinane (Waterford, Sinn Fein)
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112. To ask the Minister for Health her plans to reduce children's orthopaedic waiting lists; when the independent clinical review of spinal services at Temple Street is likely to be published; and if she will make a statement on the matter. [24428/25]

David Cullinane (Waterford, Sinn Fein)
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What are the Minister's plans to reduce children's orthopaedic waiting lists? When is the independent clinical review of spinal surgeries at Temple Street likely to be published? I have a number of other questions that I will get to when I respond to the Minister.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. I will update the House that I have now met all of the advocacy groups representing the children, young people and families affected by spinal conditions. I thank them sincerely for their time and their honesty. I have heard directly from them about the impact that gaps in communication and long waiting times can and do have on children and families and I have assured them of my commitment and the commitment of this Government to improving paediatric spinal services.

By way of background, the House will be aware that more than €30 million has been allocated to reduce waiting lists in this area over recent years. Targeted initiatives have been making some difference in how we deliver spinal services. It is important to point out that CHI has a ring-fenced theatre providing dedicated capacity. GPs can now access a clear referral pathway to prioritise urgent cases. Additional outpatient clinics have seen more than 600 new patients, which has reduced the waiting list for initial assessment by 40% year on year. We need to maximise capacity. Surgeons have been given the pathways to do so through national and international outsourcing.

These initiatives are driving some progress. In 2023, 513 spinal surgeries were completed, which represents a 35% increase on 2019. The initiatives are delivering results for many children and families, although I accept not for all. The number of children waiting longer than four months dropped by 37% last year. At the end of April, 68 children remained on active spinal waiting lists for longer than four months. This is an 18% reduction compared with last year. However, as I have told the House before, what matters is the Sláintecare targets.

We must not let the numbers distract from the reality. Progress on the part of CHI and the people in charge of delivering these surgeries has been too slow. Too many children are still waiting. The operational plan I received for spinal services did not propose a significant level of activity to meaningfully address the waiting lists or a level of activity that is commensurate with the level of investment that has been put in.

When I met the CHI board on 14 and 28 April, I made it clear that addressing these waiting lists is a top priority and that we need a new and much more ambitious plan. I have asked for a revised plan to be submitted without further delay that effectively addresses the waiting list, obviously with the focus on the longest waiters and recognising the various levers that have been provided to the Government.

David Cullinane (Waterford, Sinn Fein)
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As far back as 2017 the same families were told that this was a top priority. The Minister might recall that Simon Harris at the time gave a clear and unequivocal commitment to reduce waiting lists and that no child would wait longer than four months. That point was restated by the next Minister for Health, Stephen Donnelly. He said that by the end of the year just gone no more than 20 children would be waiting longer than four months. The figures, of course, tell a different story with 3,400 children on waiting lists for their first orthopaedic outpatient consultation, 230 children on spinal surgery waiting lists and 137 active waiters. There are now 48 children who are waiting six-plus months for their surgeries. As this has increased from 37, rather than going down the number of people waiting has gone up.

I asked the Minister also about the clinical review in Temple Street, which is being carried out by Mr. Nayagam. I have asked about this review time after time. When are we going to see it? There is no draft or interim report and no update. I know these things take time but it is really important to restore confidence in Children's Health Ireland, CHI, so that we get some sense as to when these reports will be concluded, and that we can see what is in them.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I will respond to the second part of the Deputy's question. In respect of both reports the Deputy and I await, which are very important reports that everybody is entitled to see, I am given to understand by CHI that they expect to receive them very shortly and in the next number of weeks. I feel as though I have said that before, however, and I really do expect to receive them. As I have said to the House previously, it is not directly within my control but I do expect to receive those very shortly.

On the broader question of addressing the lists and the times, as we discussed previously, the more referrals and more outpatient clinics there are, the more people will be added to the waiting list. That is okay. What is not okay is the duration of time they are waiting. To be clear, the Government has provided significant additional funding, which has resourced an uplift in staffing and provided additional infrastructure. If Deputies opposite were saying there was no theatre or there was no ring-fenced bed or there was no increased access to MRI or there was no additional surgeons or provision for it or if they were saying there was no investment enabling national and international outsourcing to three additional sites in Ireland, as well as two hospitals abroad in the UK and the US, I would accept all of those things but all of those things have been done and there is no excuse for not getting on with dealing with the cases that need to be dealt with.

David Cullinane (Waterford, Sinn Fein)
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The Deputies are simply saying that eight years ago, promises were made and here we are with these issues still not resolved and waiting lists nowhere near where they should be. I want those waiting list to come down. I want children to get to services they need. I was not the one that made the promise. I certainly was not in the room when commitments were given on what capacity would be needed to meet those promises. I can only hold the Government to account based on where we are at the moment.

The Minister raised the issue of hip dysplasia in that report as well, or a review she is waiting on. The Minister will know that I received a response to a parliamentary question this Friday gone, which was covered in the media today. It says that the letters that issued in recent weeks in relation to families and patients who had hip dysplasia procedures since 2010 were to provide reassurance and information about the audit and to ensure all potential cases were included. I do not know what that means and it has not been properly explained. We have been chasing CHI to give us this information time and again but we still do not know. Nobody has answered the question as to how many letters were given to parents. Surely to God CHI has that information, can give it to the Minister and then the Minister could tell parents and families. I do not know why that information is being concealed from us. In my view there is no good reason as to why that should be the case.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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We are making the same case with regard to CHI and spinal surgeries. I am simply making the point that surgeons have to respond to the investment that this Government and this House has put into the services. I expect them to do that.

On CHI and the hip dysplasia, it is a matter for CHI to give that number and to be able to confirm that. I will use every power I have to make sure they do that. I will request they publish that number and there is no reason not to. By way of caveat, I do understand that the reason for the numbers going back to 2010, which I gave to the Deputy in reply to a parliamentary question, is that any follow-up requirement relates to skeletal maturity, which is typically around 15 years of age. This is a clinically based decision as opposed to any other set of criteria. It is really important that CHI confirms the number of letters it has sent. It is not just CHI, it is also Cappagh hospital. They are two different numbers. I expect CHI to provide that and that the HSE would have provided that by now. I expect this information to be clear but I do expect it will continue to evolve. The most important thing is that we get the report, which will stand us all in much better stead on the next steps we must appropriately take.