Tom Clonan (Independent) | Oireachtas source

I thank the Minister of State for coming here today. I was informed last night that it was she who would be here. I was very pleased to hear that, not only because she is my local representative, of course, but also because I know her to be a person of absolute intellectual and ethical integrity. I know that the Minister of State will understand the import of the matter I am going to raise here. We may be distracted by, let us say, matters in RTÉ or the cost overruns in the children's hospital, but in the context of the concerns I am raising, these are irrelevant. Here we are talking about young lives. I have raised here before the issue of more than 200 children on waiting lists for spinal surgery in Temple Street and Crumlin hospitals. This has happened on the watch of Children's Health Ireland and its senior executive team and CEO. While those children are being failed, it has also been brought to my attention that children on the urological waiting list are also being failed. When we fail children, adolescents and young adults consistently over time without a meaningful intervention, in my mind it becomes almost a form of institutional abuse.

I want to be specific on the issue of the urological surgical waiting list. In the international medical community, the recommended model of care for children, and young adolescents in particular, on the urological waiting list is called the transitional model of care. It has been in place in the National Health Service in the UK since 2002, for more than 20 years, and in the United States since about 2005. We do not have a transitional urology programme on the watch of CHI. For these children who need surgical interventions approximately every 18 months as they develop from children into young men and women, these interventions are not taking place in Ireland. While there should be an 18-month therapeutic window, the average waiting time for a child in Ireland - these are disabled children, many of whom have cerebral palsy, spina bifida or other conditions - to get a first consultation to be seen by a urologist is an average of 2.5 years followed by a further 2.5 years to get surgery. That is five years. What is happening during those five years? I am sorry to say, many girls need vaginal reconstruction, which is not happening. This has a knock-on effect on their psychosexual development, their sexual development and their fertility. Boys can suffer from erectile dysfunction or have penises that are permanently bent for want of a little surgical intervention on the way. This leads to erectile and ejaculatory dysfunction. These issues lead to an increased risk of cancer. In the case of colorectal cancer, a person who does not have these interventions has a one hundredfold greater chance of contracting colorectal cancer. For bladder cancer the increase is six hundredfold. These interventions are not happening. We have young disabled Irish men and women, children and teenagers who suffer from infertility and incontinence and whose kidney function is affected. They suffer from UTIs. Many of them are wet and have to wear incontinence pads. These are children trying to go through their little development milestones and their urological goals are not being met.

I have no confidence in the executive management team of CHI. When we consider that it is about to oversee the transition of services from Crumlin and Temple Street to the new hospital site, the Government has to intervene and put in place a team of people who are actually competent to do this.I would appreciate it if the Minister of State could communicate the sheer import of this to her colleagues at Cabinet. The questions “When did you know?” and “When you did know, what did you do about it?” will be asked.