Peadar Tóibín (Meath West, Aontú)
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82. To ask the Minister for Health the number of persons on the scoliosis waiting list for surgery at CHI hospitals at present; and the steps she is taking to reduce waiting lists. [51548/25]

Peadar Tóibín (Meath West, Aontú)
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It is now eight years since the Minister's predecessor, Simon Harris, said that no child would be left waiting for longer than four months for a scoliosis operation. This time last year I asked him how many children had been taken off operation waiting lists without their parents knowing. He stated he would find out. However, as yet, there is no evidence that he has found out and let us know. Does the Minister know how many children were taken off the waiting lists without parents knowing, in a similar manner as to what happened with Harvey Sherratt?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. There is an audit going on into equity of access on waiting list management. I expect to have that audit at the end of November. I will have to wait until then to confirm any figures. At the end of August this year, there were 135 patients on the CHI spinal active waiting list, compared with 150 in August 2024. That is a reduction of 10%. Outpatient lists are also down, with a 45% reduction in the number of new spinal outpatients waiting on an appointment. While I recognise this progress, there is an awful lot more work to do to drive improvements in spinal services. I have met with families and advocacy groups, and it is important to listen to them.

The Deputy is more than aware that €30 million was allocated to reduce waiting lists in different areas. There is a ringfenced theatre providing dedicated capacity. There are additional outpatient clinics, in particular this year on Saturdays, which have seen over 800 additional patients, and which has reduced the waiting list for initial assessments. We are trying to maximise capacity through national and international outsourcing. As I said earlier, which I appreciate the Deputy was not here for, there is an awful lot more work to do there. I am trying to explore additional options.

Activity has increased with 342 spinal procedures completed so far this year, compared with 304 for the same period last year. This is a 13% increase, but at the same time we are seeing a growing need for those services. There are 370 spinal patients who have been added to the CHI active waiting list, which is a 10% increase compared with last year. While some of this reflects faster outpatient access and better referral pathways, we are also trying to do further analysis to understand some of the source of that demand, which is really important. The services remain an absolutely top priority and I will do everything I can to actively drive progress to address the challenges children face.

Peadar Tóibín (Meath West, Aontú)
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The Minister must admit it is quite shocking that it will take 14 months for a question asked in September 2024, about how many children have been taken off waiting lists without their parents knowing, to be answered. It points again to the dysfunction. I welcome that the Minister has met with parents about this. That is a good thing. The Minister mentioned money going into this section. Some €11.6 million was provided to outsource operations abroad for children who need it. As of now, there is no child scheduled for operations abroad. This shows that while money is being provided, it is meaningless if it is not making a practical difference to the lives of these children. The 2024 report of CHI has also not been published. That is scandalous. The 2023 report, in fairness, states that CHI is sitting on approximately €36 million at the moment. My understanding is that it is not spending it because that money has been assigned to fit out the new children's hospital.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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No.

Peadar Tóibín (Meath West, Aontú)
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Is that the case? The Minister might answer that.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I do not believe so. There is a separate portion of money to do that, so I do not believe that. I will check, but it is certainly not my understanding. I remain concerned about the number of children referred, or not referred, for international surgery. As I said earlier it is a source of deep frustration to me that those services are not being utilised. Part of the audit is an analysis of equity of access on the waiting lists, which is something we have not done previously. This qualitative assessment involves talking to parents and patients and asking them how they ended up in Blackrock, for example, and what the pathway was. I have spoken to parents who told me that the international option was not provided to them or was provided to them too late in the process. I am not clear on it, but I asked for an audit into spinal services, neurological surgery and another medical area in CHI precisely to try to determine that, such was my concern.

Peadar Tóibín (Meath West, Aontú)
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I think the Minister understands this perfectly well. Given that it has been so hard to get information from CHI over the last number of years, anything less than a statutory inquiry into the lack of care for children on scoliosis waiting lists is not going to get to the truth. The fact that there has been no information forthcoming from the individuals involved means that if we cannot compel people and papers to find out the truth on this, we are simply not getting to the facts.

I have been here for a while and I have heard of inquiries being announced in tandem with campaign groups, and it being said that the terms of reference will be agreed by the campaign groups. However, when it comes to the inquiry being set up there has been a separation from the actual campaigns. Will the Minister ensure there is no such separation from the families, and that the terms of reference of such an inquiry are fully in sympathy with the needs of the families when they are announced?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I updated the House earlier. They should be fully in sympathy. I also recognise that whoever is leading the inquiry will need to clarify the terms and make a final decision on what they need to be. I anticipate a comprehensive and transparent inquiry where the terms of reference are developed in partnership. The Government is one piece. The advocates are another piece, as is the person leading from both a legal and a clinical perspective on how that is best done.

I updated the House on some of my thinking about this. I am conscious that I spoke with regard to other forms of inquiry, where the public nature or the particular model of statutory inquiry precludes the information in that inquiry being used for any other purposes. We look in particular at Limerick, where for the first time ever in the health system, there are a number of serious disciplinary proceedings happening there, particularly in relation to the Aoife Johnston case and the circumstances of that.

There was review done by Frank Clarke, which had significant powers. I have spoken with Mr. Justice Clarke since to ask if powers of compellability would have made a difference to him. He was satisfied with the model he had. It is my responsibility to scope out the different models and express the pros and cons of the different models. We will ultimately have to agree the nature of it in partnership, but I am conscious of the need for whoever is leading it to be able to do a good job and have their appropriate powers, the requisite timeframe, support and all of those different things. We just need to work out what model is going to work best for that.