Mary Lou McDonald (Dublin Central, Sinn Fein)
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I offer condolences to everyone who loved Garda Kevin Flatley: his heartbroken wife, Una, and their two children, Aoife and Erin; his parents, family and friends; and, of course, his colleagues in An Garda Síochána. He was a devoted father, a man with a deep grá for community and a GAA man with his beloved club, O'Dwyer's in Balbriggan. His death is a devastating reminder of the dangers faced by gardaí as they keep us safe. Tá fear maith caillte ag a chlann. Tá garda den scoth caillte ag a phobal. Seasann an tír ag caoineadh leo. A good man is lost to his family, a great garda is lost to his community and the country mourns with them. Ar dheis Dé go raibh a anam dílis.

The controversy regarding unnecessary hip surgery carried out on children in CHI hospital has deepened. The Minister for Health has finally confirmed that parents are receiving letters about operations on children as far back as 2010. This is the first confirmation from Government that this scandal goes back at least 15 years, and not the two-year period previously asserted by Government.

We have been raising this issue with the Taoiseach and Tánaiste for weeks. We did so because we had been contacted directly by parents literally at their wits' end, having received letters from CHI regarding operations their children had 15 years ago.

We have been raising it with the Taoiseach, conscious of all of those parents who are now asking themselves whether their children were operated on unnecessarily, how this could have happened and what the consequences are. Each time the Taoiseach has been questioned on this scandal, he and Simon Harris have responded with non-answers. They have refused to give clarity and so parents have been stonewalled by CHI and the Government.

After weeks of trying to contain the truth, we have, finally, in black and white from the Minister for Health confirmation that letters have been issued to parents of children who had operations 15 years ago. The Minister's response to Teachta David Cullinane states that letters were issued "in recent weeks to families and patients who had hip dysplasia procedures since 2010". She said this was “to provide reassurance and information about the audit, and to ensure all potential cases were included”. The truth is that the Government has given neither information nor reassurance to parents. In fact, it has been ducking, diving and dodging. The Minister has now accepted there are cases going back to 2010, which means the investigation is not limited in the way the Government had previously claimed. In fact, it stretches back 15 years at least. If the 2021 to 2023 audit recalled 561 children - this we know - how many children in total are subject to recall in the full look-back process? Is it hundreds? Is it thousands? What is the number?

The Minister for Health also says an action plan is being prepared. She states that the plan will include the identification of groups of patients not included in the audit sample but who may be affected by any findings of the audit. Will the Taoiseach explain exactly what that means? Will he tell parents sick with worry who may be listening today what precisely all of this means for their children?

Tar éis don Rialtas cúpla mí a chaitheamh ag diúltú freagraí a thabhairt, tá deimhniú faighte againn anois go dtéann an scannal maidir le hobráidí ar chromáin chomh fada siar le 15 bliain ó shin. Tá an fhírinne iomlán tuillte ag tuismitheoirí.

The parents of children caught up in this hip surgery scandal deserve answers and the full truth. Now we know this scandal goes back 15 years at least. Will the Taoiseach finally tell us how many letters have been issued to parents and how many children have been recalled? Does this go back even further than 2010? How many children are involved?

Micheál Martin (Cork South-Central, Fianna Fail)
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At the outset, I also extend my deepest sympathies on the floor of the House to the family, friends and colleagues of Garda Kevin Flatley. Our thoughts and prayers are particularly with his wife Una and his daughters Aoife and Erin. He died in the line of duty, which is a reminder to us of the dangers that members of An Garda Síochána go through day after day as part of their mission to keep us all safe and prevent crime. He was an outstanding community person, as many gardaí are. They not only give duty in the line of service but, outside of their duties as members of An Garda Síochána, they are pillars within our communities, helping sporting organisations, in this case with Kevin helping O'Dwyer's GAA club. We extend our sympathies to the broader force and to all members of An Garda Síochána at what it is a very difficult and traumatic time for them, and a huge blow to the force.

Regarding the clinical audit that is being conducted in respect of developmental dysplasia, in the first instance, it has to be said that there is a lot of anxiety and concern. A lot of parents would be worried because for a child to go through an operation or surgery is very traumatic for a child and very traumatic for the parents. Anything we do here must be done with that in mind, so we are very conscious of the anxiety that can be added to or created by anything we say or by piecemeal information or a drip-feed in respect of this issue.

The Minister has taken the correct decision in terms of establishing a clinical audit by an external international expert on surgery for children with developmental dysplasia of the hip across the CHI and the National Orthopaedic Hospital in Cappagh. As the Deputy knows, that audit was carried out after concerns were raised that different standards and surgical practices were being used for DDH at CHI Temple Street and Cappagh.

The purpose was to assess whether the standards and surgical practice used in CHI and Cappagh were in keeping with international standards of practice. Concerns had initially been raised under a protected disclosure in September 2023 and the Department was notified on 9 May 2024. There was some delay to the starting of the audit as the surgeon who had originally agreed to carry out the audit was no longer able to do so. Therefore, it was necessary to secure the expertise of another paediatric surgeon.

The clinical audit was conducted on a random anonymised sample of patients aged one to seven years of age who had these procedures between 2021 and 2023 in CHI and Cappagh. The audit process is now at a very advanced stage. It is understood the audit author has received final feedback and fact checking from the clinicians to whom the draft report was circulated. We all know this is standard procedure in respect of audits of this kind. We do not have a final timeline from the HSE or CHI for when the report will be fully complete and provided to the Minister. Pending completion of the audit report, and as a patient safety precaution, all DDH cases are now being reviewed by a single team of clinicians from CHI and Cappagh before any decision for surgery is made. This process has been in place since March 2025.

Deputy McDonald is correct that an action plan is currently being drafted in advance of the final audit report. This plan includes the identification of groups of patients not included in the audit sample but who may be affected by any finding of the audit. Plans are being put in place for patient follow-up in line with good practice and will, of course, consider any recommendation with regard to clinical follow-up from the final report.

CHI and Cappagh have issued letters in recent weeks to families and patients who have had a hip dysplasia procedure since 2010 to provide reassurance and information about the audit and to ensure all potential cases. Those letters went out after media reporting of a draft audit report. It was found necessary after that to communicate to parents as a result of reports of a draft report. The Minister cannot comment on it because she has not received a report. It is critical that the Minister would get a report.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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Thank you, Taoiseach.

Micheál Martin (Cork South-Central, Fianna Fail)
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We can come back on it later. The fundamental point is that no one is ducking, diving or dodging anything and it is unfair to suggest that. We want completion. It is far better for everybody if a complete report is issued and published, and then we can act on it.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The anxiety of these parents could not be overstated. As the Taoiseach has correctly noted, the initial sample between 2021 and 2023 involves children between the ages of one and seven. These are very young children, and the idea of any small child being operated on unnecessarily is extremely traumatising for their parents. Their anxiety has been added to by the Government's absolute lack of clarity and the Taoiseach's refusal even today to answer basic questions of information. How many letters have been issued and how many children are involved? The parents concerned want to know this. The system wrote to these parents. It raised this issue with these parents with regard to the children in these families. Having raised the issue, however, no clarity is given. No reassurance has been given. This is the truth. Can we start the process of clarity today? Will the Taoiseach simply tell me how many letters have been issued and how many children will be recalled? The Taoiseach ought to know that at this stage.

Micheál Martin (Cork South-Central, Fianna Fail)
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If Deputy McDonald does not mind me saying so, she is being somewhat disingenuous. Nobody is stonewalling and no one is refusing to give information.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Then answer the question.

Micheál Martin (Cork South-Central, Fianna Fail)
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I thought the obvious thing to do, and we may have this sooner than Deputy McDonald might think, is to wait for the audit report to be published and given to the Minister. That is logical. Otherwise, all Deputy McDonald is asking for is drip-drip and bits of information here and there,-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The letters have gone out.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----which would only add to the anxiety and concern of parents.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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No.

Micheál Martin (Cork South-Central, Fianna Fail)
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Yes.

Pearse Doherty (Donegal, Sinn Fein)
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The letters have been issued.

Micheál Martin (Cork South-Central, Fianna Fail)
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If I may, I did not interrupt.

Experience tells me that when we ask someone to do an external audit independent of politicians and Government, we should just let them finish their work and have the totality of their work available for us to assess, and then take action based on that. Of course, that audit has to be shared with the public, the parents, in the first instance, and the patients. There is always follow-up of children who have surgery for this particular condition and that follow-up would take place right into their teenage years, the ages of 14, 15 and 16.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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I am aware of that. The Taoiseach is refusing to confirm how many letters issued and how many children are involved.

Micheál Martin (Cork South-Central, Fianna Fail)
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The Deputy clearly then understands the context-----

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I ask the Taoiseach to conclude.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----of why they will be written to.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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It is outrageous.

Ivana Bacik (Dublin Bay South, Labour)
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I begin by offering my deepest condolences also to the family of the late Garda Kevin Flatley, his wife, Una, his children, Aoife and Erin, his entire community and his colleagues in An Garda Síochána. On behalf of the Labour Party, I pay tribute to Garda Flatley and the dangerous work he did, and all his colleagues do, in front-line policing. We all owe them an enormous debt for keeping our communities safe and we all think of that as we hear the awful news of his tragic death.

I also express sympathies to the families of the two young boys, Emmanuel Familola and Matt Sibanda, who died so tragically in a drowning incident in Buncrana, County Donegal. Those tragedies really brought home to us the dangers posed by water and the risk of drowning.

To have just one home lying vacant during a housing crisis is unforgivable but the level of vacancy and dereliction in Ireland today is an outright scandal. Approximately 160,000 homes are lying empty across the State or, rather, we think that is the number lying empty because the truth is that we simply do not know. On every street in every town, we see vacant buildings, vacant houses and voids, which are visual evidence of the failure of Government housing policy. We were all reminded of it yesterday with the news of the collapse of a terrace of Victorian cottages in my home area. Just along the Grand Canal, as morning commuters travelled to work and school, a terrace of houses, ironically, owned by and right adjacent to the Construction Industry Federation headquarters, collapsed. It was embarrassing for the CIF, for sure, but it was lucky that nobody was injured in the collapse. Emergency services had to be called to clean up the mess.

That is just one stark example of the scourge of vacancy and dereliction. Vacancy blights more than just streetscapes because whenever I raise it in this House, as I have many times, I see vacant stares on the Government side. Nobody in government seems to know the scale of the problem. It simply does not know how many empty homes there are in the country and the already minuscule tax on those homes is not being paid by those who are sitting on them and failing to put them to use. The lengthy bureaucratic compulsory purchase process has been simply ineffective in tackling this issue. It is not as though this is an issue that has just crept up on the Government. It should, by now, have worked out how to find out the scale of the problem and, crucially, how to tackle it. Yet. five years since Fianna Fáil took on the housing brief, no one in government is showing any ambition to get to grips with the problem of vacant homes. so we get vacant stares, vacant ministerial offices and vacant Government policies. We are told the Central Statistics Office is researching the extent of vacancy over past years and that will be welcome. What we do not know is how the Government will use that information.

Weeks ago, my colleague, Deputy Conor Sheehan, in a parliamentary question, asked the Department of housing to explain why vacancy has not been tracked but that portion of the question was not answered. When will we see the Department of housing take on the basic task of determining how many homes are lying empty? When will we hear from the Minister for housing about plans to tackle dereliction and vacancy and to supply local authorities with adequate funding so that they can take on this task?

Micheál Martin (Cork South-Central, Fianna Fail)
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I disagree with the Deputy's analysis of the Government's response to vacancy and dereliction. The vacant homes action plan progress report 2025 highlighted the breadth of action the Government is taking to support bringing vacant properties back into use as homes. Key areas of progress include the successful delivery of the vacant property refurbishment grant, with over 11,300 applications received, 7,700 approvals and over 1,400 grants issued as refurbishment works are completed. That amounts to €77 million paid out to support people bringing empty dwellings back into use as homes.

I have seen this all over the country. I have seen villages that had three or four derelict properties now without any derelict properties because people have availed of the derelict grants.

This is a very innovative approach that was taken by the last Government. It was introduced by the Minister, Deputy Darragh O'Brien. I was a strong supporter of it. It is a game-changer in respect of many derelict properties the length and breadth of the country. The vacant house grant is also quite significant. It facilitates the return of vacant houses as viable homes for people.

The latest available vacancy data from GeoDirectory comes from quarter 4 of 2024 and notes a decrease in the national vacancy rate to 3.8%. That is the lowest recorded since 2013. I take the point that there are different data sources but the overall trend is downwards and vacancy levels are reducing.

The standard answer today is more and more funding for everything but, in 2021 and 2022, we gave substantial funding to local authorities to deal with voids in their own local authority housing stock. Local authorities take too long to release homes that have been vacated. When homes are vacated because families have left or moved on for different reasons, it can sometimes take months or a year for the local authorities to fill those houses. They cite all sorts of reasons but it is not good enough. They are now looking for more grants to fill those houses. Voids should be filled fairly quickly. It should happen within a week or two of the house being vacated unless there is some structural issue. In the majority of cases, there are no structural issues because families have been living in them already. We need to keep pressure on where it matters. By all means, resources will be released. The resources being released for social housing, including voids, new builds and acquisitions, are way above anything that has been allocated in the last decade. There is no argument about that. However, there equally should be no argument about local authorities also having a razor-like focus on dereliction within their own domains. Local authorities should use and enforce the Derelict Sites Act. They should also make sure that voids under their remit are filled quickly.

Ivana Bacik (Dublin Bay South, Labour)
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Of course, we support any initiatives that will help to tackle the scourge of vacancy and dereliction but it is simply not good enough for the Taoiseach, as leader of the party that has held the housing brief for five years, to pass the buck to local authorities. That is not good enough. He speaks of a "razor-like focus" on tackling vacancy and dereliction. That is exactly what we are not seeing from his Government and his Minister for housing. We are seeing an absolute vacancy as regards policy. We hear from our councillors across the country that the resources available to local authorities to tackle voids are diminishing. Central government is undermining the capacity of local authorities to tackle vacancy and dereliction. We in Labour have supported local communities in bringing forward reports of vacant and derelict buildings and houses to local authorities so that we can help to be part of the solution to the problem. However, what we hear from our communities is immense frustration at delays in the process, the slowness of responses and, crucially, a lack of funding for local authorities from central government. It is not good enough for the Taoiseach to say that local authorities are not doing enough. The impetus and the driving focus must come from central government and from the Department of housing. That is precisely what we are not seeing at present. That is really evidenced by the collapse of derelict buildings as we saw so graphically yesterday.

Micheál Martin (Cork South-Central, Fianna Fail)
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Ní aontaím leis an Teachta in aon chor. Níl an ceart aici. Ní raibh na deontais atá ann anois maidir le tithe atá folamh agus mar sin de ann riamh. Is léir sin ón méid daoine atá ag fáil deontas sa lá atá inniu ann. I do not agree with the Deputy. The refurbishment grant for derelict buildings was not there four years ago. It has had a very significant impact and the Deputy should be good enough to acknowledge that.

Ivana Bacik (Dublin Bay South, Labour)
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We welcome anything.

Micheál Martin (Cork South-Central, Fianna Fail)
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The only criticism I remember was that a TV programme gave details of the grants. It was considered politically wrong to let the public know they could avail of a grant if they wanted to buy and refurbish a derelict building or vacant house. These grants have been spectacularly successful and we need more of them.

Some local authorities have been good on social housing but others have not been. We need to call that out.

Ivana Bacik (Dublin Bay South, Labour)
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Where is the central leadership?

Micheál Martin (Cork South-Central, Fianna Fail)
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It is not always about handouts. You can go around certain local authority estates and see six vacant houses. Millions are not needed to put those houses back into use. They should never be vacant for beyond a month. I am not just saying this now; I have said this to local authorities time and again. We have taken void initiative after void initiative.

The dependency culture kicks, that they will fill a void if given €50,000 or €60,000. No. If a house is idle because someone left it a month ago, it should be allocated again. We are in a housing crisis.

Cian O'Callaghan (Dublin Bay North, Social Democrats)
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On behalf of the Social Democrats, I extend our deepest sympathies to the friends, colleagues and family of Garda Kevin Flatley. Garda Flatley lost his life while serving the community to keep us safe. Our thoughts are with all those mourning this terrible loss, his wife Una, and his children Aoife and Erin.

The State is continuing to fail children with additional needs. All over the country there are hundreds of children who do not have a school place or an appropriate school place. The damage this is doing to children, to their development and their well-being is unforgivable. The stress and anxiety this causes families is incalculable. Now a number of families have been forced to take legal action against the State over its failure to provide their children with an education. One mother who was taken a case has an eight-year old child with autism who has never attended school. In a sworn statement, she told the High Court, “The sad truth is that if I never sent [the boy] to school, nobody would know and nobody would care”. The really awful thing is that this mother is right. Children with additional needs do not enjoy an automatic right to education. Every year hundreds of these children fight to get a school place. Their parents must beg, plead and cajole, and ultimately take legal cases to vindicate their rights, all so their children can get a place in a classroom. Despite these efforts, they are often unsuccessful. This relentless battle with the State, which should be there to support these families, is all-consuming, draining and exhausting. It is bringing many parents to the brink.

Successive governments have promised to address this scandal but still children with additional needs are not just failed, they are consciously failed. The State either does not care enough to provide appropriate school places or it lacks the competence to do so. These families are not looking for special treatment. They just want their children to have the same rights as other children in the State. They want them to be able to learn and develop to their maximum potential. They want them to be able to enjoy the routine and activities of a school day. They want them to be able to socialise and make friends with other children. This is all they are asking for. Families with children who have additional needs are fed up with platitudes and they are fed up with broken promises. They want to see action.

Will the Taoiseach tell me whether the State will be fighting these families in the cases now before the courts? Will he give a commitment that every child in this country will have an appropriate school place in September?

Micheál Martin (Cork South-Central, Fianna Fail)
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First of all, every child is entitled and has a constitutional right to an education. It is our job as the Government to vindicate that right. I do not accept the Deputy's presentation that the Government does not care. The Government does care. There is evidence of that. I do not want to go through all the statistics as that does not console a particular parent or family who are having difficulty in getting confirmation of a school place for next September.

Expenditure has increased exponentially in the special education area, and rightly so. It is now about 28% of the education budget, with a 48% increase since 2020. We now have about 124 special schools, with 11 opened since 2020. There had been a lapse before 2020 but since 2020 we have opened new special schools and built 11 of them. Five more are opening in 2025-2026. The number of children attending special classes in mainstream schools has doubled over the past five years from just over 9,000 in 2019 to almost 19,000 in 2024, with 3,335 special classes now in place to support them.

We are planning a substantial number of school places for this year. Some 3,900 places will be available for 3,275 students known to the National Council for Special Education, NCSE, who are seeking special classes and special school places, through additional capacity.

There is a challenge and intensive work is ongoing. I have been in touch with the Minister of State with responsibility for special education and inclusion, Deputy Michael Moynihan, and with the Minister, Deputy Helen McEntee, on this issue and particularly in the Dublin area in endeavouring to get specific confirmation around students who have yet to get a place confirmed.

Some of the issues relate to getting the sanctioned special classes ready before September. They will definitely be provided, as they have been sanctioned, but I am referring to the logistics of it. In some cases it could be Portakabins and in others it may be a matter of getting new facilities in place. No effort will be spared to make sure everyone gets a place rather than having people seeking to vindicate their rights through the courts. I do not want that. There has been a significant increase in terms of children presenting with special and additional needs. Work is also ongoing in terms of the NCSE and the Department getting far better at predicting and having databases for the future through the former whereby the application dates will come forward earlier in the year and we will have a common application system nationally for children with additional needs. This issue is being given intense attention by the Government right now to give that assurance to parents.

Cian O'Callaghan (Dublin Bay North, Social Democrats)
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I thank the Taoiseach for his response. Families have heard these promises before. There is a world of difference between a sanctioned classroom and a classroom that will actually open in September. A child cannot go to school in a classroom that is just sanctioned; it has to be up and running. No family should have to fight to get an education for their child and no parent should have to take legal action against the State to vindicate this right. A total of 399 new special education classrooms have been sanctioned for the next school year. How many of them will be open in September? The Taoiseach did not answer me. Will the State be fighting these cases that have been taken by parents and families? Is he able to give a commitment that every child will have an appropriate school place in September?

Micheál Martin (Cork South-Central, Fianna Fail)
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The Deputy is correct. As I said, 399 new special classes for the next year have already been sanctioned in the past month. This has been done much earlier than in previous years. I do not have a detailed report in terms of each particular class. There are many with which there are no difficulties, but there are some in respect of which there are difficulties in terms of the logistics of getting them built, getting modular buildings in place or in terms of planning. Again, I am working with the Minister, Deputy McEntee, and the Minister of State, Deputy Michael Moynihan. They are working extremely hard on this issue with the NCSE.

Níl aon amhras faoi sin. Tuigimid go bhfuil brú ar thuismitheoirí. Tuigimid go bhfuil géarghá do roinnt ranganna agus níl sé cruinn fós an mbeadh áiteanna ag roinnt acu i Mí Mheán Fómhair, ach táimid ag déanamh ár ndícheall chun go mbeimis sásta go mbeadh na háiteanna ann an Meán Fómhair seo chugainn. We will do everything we possibly can to make sure that every child has a place next September, and certainly has visibility in respect of a place in the next school year. We will work flat out to make sure that becomes a reality.

Peadar Tóibín (Meath West, Aontú)
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I, too, offer my deepest sympathies and the sympathies of Aontú to the family of Kevin Flatley. This is a disaster for Kevin's family and friends. It is also a disaster that 90 gardaí have lost their lives in the line of duty since the foundation of the State. Many families fear when their parent or loved one goes out to work that they might not see them come back. Yet, those people still commit to going out and working for our safety on a daily basis.

Families are struggling to get healthcare for their children on a daily basis. The dysfunction in the healthcare system is leading to enormous delays and difficulties for families. We have a situation where families actually managed to get operations for their children. As we found out, in many cases those operations were unwarranted and unnecessary. It is currently a major problem within the State that children who may not have reached the threshold in terms of hip surgery or who may not have suffered from hip dysplasia in the first place may potentially have had operations carried out on them.

I understand that 561 people were included in the audit carried out over the past two years. If the audit is to look back 15 years, however, we could be talking about thousands of parents and children being involved.

I had to leave my son in an operating theatre for a procedure. It was not as serious as the ones we are talking about at the moment, but I saw the fear in his eyes before I left the theatre. It was very difficult to leave that location. Imagine the fury that must exist among the thousands of parents who left their children in difficult circumstances in a situation where potentially the operations there were undergoing were not necessary and could have damaged them. All operations involve challenges. Infection and surgical trauma are possible. It is a serious issue when an anaesthetic is administered to a young child.

Potentially thousands of parents have been left in limbo. For many, there is an excruciating absence of information. This is the real difficulty for them. They want to know how this happened and how hospitals could carry out particular operations at a rate five to ten times higher than the population of the country needed and no one seemed to pick up on it. What Government structures allowed this? Where was the leadership in the hospitals where this happened? What culture facilitated this? Where were Children's Health Ireland, CHI, and successive Ministers for Health during the 15-year period in question? The Department of Health is responsible for all those aspects of our health services. We are asking parents to have confidence in what is happening in respect of their children, yet we cannot tell them what happened to other people's children over the past 15 years. If the idea of the audit is to try to make-----

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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Thank you, Deputy

Peadar Tóibín (Meath West, Aontú)
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-----sure this never happens again, surely there is an urgency in seeing to it that the audit is completed as soon as possible. When will parents know what happened to their children?

Micheál Martin (Cork South-Central, Fianna Fail)
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I thank the Deputy for raising this issue.

I join Deputy Bacik - I omitted to do so earlier - in expressing my deepest sympathies to the families of Emmanuel Familola and Matt Sibanda and the community in Donegal on the sad and shocking drownings at the weekend of the two young teenagers who were enjoying themselves with their friends. What happened made for a very sad weekend altogether.

In respect of the issue raised by Deputy Tóibín, the audit will not look back 15 years. The audit that is currently being conducted relates to a random, anonymised sample of patients aged between one and seven years for the period 2021 to 2023. Letters have issued from CHI and Cappagh hospital to parents. That is not an audit, however. The clinical audit by the external author is as I have just described. We need to await the completion of that audit. I accept the concerns and appreciate that the absence of completion or information can compound anxiety for parents. That is why it is important that we get the complete audit and that we are in a position to share it with the parents and families, the Oireachtas and the public at large. An action plan will then be implemented and published to deal with that and to work with parents and patients.

I cannot draw conclusions until the Minister and I see the final report. The implications are disturbing, particularly if some of the assertions that were made prove accurate. In other words, if it emerges that they are truthful. There are issues. As I outlined in an earlier reply, changes to practices and protocols have already occurred in the context of a multidisciplinary approach and preoperative assessment. It seems that the latter clearly were not there in advance of this. Cases are being reviewed by a single team of clinicians from CHI and Cappagh hospital before decisions relating to surgery are made. That process has been in place since early March. As stated, in many cases if a child was operated on as far back as 2010, that child would still be getting check-ups through the teenage years.

One would routinely have follow-up until 14 and 15 years of age in respect of such surgeries, and indeed other surgeries as well. That is not uncommon. I favour the completion approach - in other words, getting the full audit out, getting it published and shared and then acting on it.

Peadar Tóibín (Meath West, Aontú)
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There are major problems in the health service that the Government can act on now that have led, in part, to the difficulties we are suffering. There is not proper data collection in our health service at the moment. There is not a proper digital patient number in the health service. We do not have a good register of information in the health service. The capture of outcomes is not valued in the health service. We do not track patients in a similar fashion to other jurisdictions to enable us to be able to flag these situations, if they should arise at all. Fixing those particular issues would be of extreme benefit to patients in the system and ensure these issues do not happen in the future. The idea that we would start to track and perhaps even pay hospitals for their activities and outcomes, instead of the manner in which hospitals are paid now, would be beneficial in ensuring that money does not get lost on the front line and get caught up in layers of administration.

My worry now is whether all the parents who could potentially be caught up in this scandal over the last 15 years have been contacted. What is the depth of information they have received? Is it a generic letter or have they been given information specific to their own cases?

Micheál Martin (Cork South-Central, Fianna Fail)
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In relation to the Deputy's general comments, a lot of huge advances have been made in our health service as well. In fact, through the various layers of management on hospital sites now, we know a great deal of data is being collected in respect of individual patients once they enter a hospital and go in for particular treatment. A lot of information is garnered in respect of every individual patient nowadays. There is a need for further investment in digital health and electronic patient records. In the upcoming national development plan, we are going to allocate substantial funding in addition to that already spent in relation to this issue. This is necessary. The health Vote in 2025 is €25.8 billion.

Peadar Tóibín (Meath West, Aontú)
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It is not getting to the front line.

Micheál Martin (Cork South-Central, Fianna Fail)
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It is getting to the front line.

Peadar Tóibín (Meath West, Aontú)
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Not what is necessary.

Micheál Martin (Cork South-Central, Fianna Fail)
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We cannot be that superficial about it. Of course it is going to the front line.

Peadar Tóibín (Meath West, Aontú)
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Some 50,000 operations were cancelled-----

Micheál Martin (Cork South-Central, Fianna Fail)
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Sorry, we need-----

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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Please, Deputies.

Micheál Martin (Cork South-Central, Fianna Fail)
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Some €25.8 billion has been allocated to health in 2025. That is six or seven times ahead of the figures from four or five years ago. The value-for-money thing needs to happen as well, and on another fine day the Deputy will be in here rightly raising those issues. He cannot have it both ways though. It is always a question-----

Micheál Martin (Cork South-Central, Fianna Fail)
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We will be allocating more to health. We do need to analyse it as well. Separate from the normal funding going into acute and tertiary services, we accept we need investment in the digital health area and we-----

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I thank the Taoiseach.