Keith Swanick (Fianna Fail)
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I also welcome Councillor Coyle to the Chamber. I thank the Minister for coming to the House to discuss this very important issue. As he is aware, my patients are in fear because the treatment they so badly require could be in jeopardy due to the constant staffing crisis which is crippling our health system.

I have listened with great sadness and shame, as has the Minister of State, to the stories of very young children and adolescents with scoliosis who are waiting inexcusably long times to receive treatment. Today, however, I am raising the issue of adults with scoliosis who are also at the mercy of long waiting lists.

It was brought to my attention by Councillor Walter Lacey that a patient of Mr. Pat Kiely, consultant orthopaedic surgeon in Tallaght hospital, was recently advised that he was no longer working in the hospital and the waiting list would be outsourced to a different hospital under a different consultant. Unfortunately for some, that is the sum total of the communication they have received.

One woman was diagnosed with scoliosis in 1995. In September 2014, she had a two-part operation carried out under Mr. Kiely and requires further treatment on her spine, specifically an injection and a fusion of the spine. In June 2016, more than one year ago, she was advised she would be seen as a priority case. In January 2017, she was advised by her doctor that Mr. Kiely had moved on and she would now be under the care of a different consultant in a different hospital. She has yet to receive any further update on her case. In the meantime, she struggles on and minds her three children despite her disability. Her GP telephoned the hospital on her behalf to be told not to ring any more. It is frustrating and is not acceptable that a health professional who is advocating for a patient was dismissed in such a fashion. Patients like her are being left in a painful limbo.

As the Minister knows, the management of scoliosis is complex and determined by the severity of the curvature and skeletal maturity, which together predict the likelihood of progression. According to the HSE's action plan for scoliosis treatment, to achieve the target of a four-month waiting list, 447 patients will need to receive treatment before the end of 2017. As the Minister will probably agree, these targets will not be met. Some 447 patients need treatment before the end of 2017. It is a significant ask for the staff of the theatres concerned to facilitate that number of patients. To lose one consultant is a major blow.

I would also like to put on the record of the House my acknowledgement of the work of Mr. Kiely. He does fantastic work in this field. He is the co-founder of Straight Ahead Ireland, which operates on a voluntary basis. Surgeons perform operations on a pro bonobasis. They change the lives of children who might otherwise have to wait longer for treatment or surgery. They do this selflessly and give up their personal time. The operations are conducted on weekends and Christmas during down times in theatres in Our Lady's Hospital in Crumlin. Mr. Kiely and the Straight Ahead team are fighting a battle against waiting lists which is not theirs to fight.

Does the Minister agree that a new approach is needed in the field of recruitment and that the current recruitment process is not working at the pace or rate which is required? When will Mr. Kiely be replaced? Will his list be addressed in Tallaght hospital or off site in a different hospital? When will the young mother of three to whom I referred be accommodated for her surgery, along with the approximately 70 other patients still on the waiting list?

Denis O'Donovan (Fianna Fail)
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The Minister of State, Deputy Jim Daly, is not the line Minister for most of these issues. He may not have all the answers.

Keith Swanick (Fianna Fail)
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I would be grateful if the Minister of State could convey my concerns to the Minister.

Denis O'Donovan (Fianna Fail)
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I am sure he will. I should not predict the answer.

Jim Daly (Cork South West, Fine Gael)
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I thank Senator Swanick for raising this issue and giving me the opportunity to provide an update to the House on the matter. I will address some of the Senator's specific queries with him directly.

Improving access to scoliosis services for patients is a priority for the Minister for Health, the Government and the HSE this year. The Senator will be aware that the HSE, working with the Children’s hospital group and the Department of Health, developed a scoliosis waiting list action plan which was finalised and published in May of this year. In tandem, the HSE is working to develop a long-term sustainable solution for scoliosis and paediatric orthopaedic cases.

The number of patients on each of the waiting list categories is being taken into account in planning future service requirements. The Minister is aware of particular concerns raised in regard to adolescent patients waiting for scoliosis surgery in Tallaght hospital. The HSE has included this cohort of patients in the scoliosis waiting list update and service development plan which sets out a short to medium-term strategy to ensure no patient will have had to wait more than four months for surgery by the end of the year, where that is appropriate clinically.

The HSE has informed the Department of Health that a process is under way for the transition of adolescent scoliosis patients from Tallaght to the Mater hospital. This has commenced, with 16 patients transferred currently. Further patients are being clinically reviewed in Tallaght with a view to transferring to the Mater. It is envisaged that a similar process will be undertaken for OPD patients and that the patients overall will remain in the care of the Mater as part of a longer-term solution for patients with scoliosis.

In respect of spinal services at Tallaght, the hospital is the principal provider of elective orthopaedics in the Dublin Midlands hospital group. The hospital’s spinal orthopaedic service provides emergency and elective access for a varying degree of acute degenerative and scoliosis spinal conditions with a tertiary referral base. It is acknowledged that spinal orthopaedic activity levels at Tallaght Hospital have fallen in recent years. There has been a reduction in consultant staffing numbers in this sub-specialty area due to consultant departures and difficulty in recruiting replacements.

However, I understand from the HSE that approval has been given by the Dublin Midlands hospital group for an additional consultant, and a new consultant is due to start following completion of his fellowship in September 2017. While the hospital currently has constraints around in-house activity, approval has also been given by the HSE for an initiative to provide an inpatient and day case spinal service in a private facility with a Tallaght Hospital spinal orthopaedic consultant, as part of its public contract, accessing facilities in the private sector to reduce waiting lists.

In addition, the reconfiguration of theatres at Tallaght hospital is being reviewed to facilitate the creation of a spinal theatre available for spinal procedures. I am confident that this range of actions will improve access to scoliosis services for patients. I will answer some of the Senator's queries in my response.

Keith Swanick (Fianna Fail)
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I thank the Minister of State and I appreciate his response. I appreciate the fact that he did not mention the adolescent scoliosis patients being transferred from Tallaght Hospital to the Mater Hospital. My concern today, of course, relates to the adult scoliosis patients. I am glad to hear that approval has been granted for a new consultant to be appointed after September 2017. Will the Minister of State confirm whether the 70 patients who are currently on Mr. Kiely's list will be transferred to the private sector to complete their treatments or if they will be transferred to the new consultant's list after he or she is appointed in September? These people have been waiting far too long and it would be my preference for them to be transferred to the private sector as a priority.

Jim Daly (Cork South West, Fine Gael)
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I thank the Senator again for raising this issue. It is an issue I had occasion to raise in the other House numerous times myself, particularly in respect of waiting lists for children. Thankfully significant progress seems to have been made on that front but I would be concerned to see any knock-on effect on the adult patient. I am not sure of the answer to the Senator's question. I will look into it for him in the Department of Health and I can get some answers for him.

On some of the specific issues the Senator raised, I would be concerned about a GP being told not to call back when they are advocating. They are the principal advocates, more so than the Senator or myself are as public representatives. A general practitioner should not be told not to call back. If the Senator would like to give me the details of that case I would be interested in pursuing it as part of my role in the Department of Health. If he sends those details to me I will follow up for him and find out why that happened. Hopefully I can get an assurance that it will not happen again.

I concur with the Senator in paying tribute to Mr. Kiely. I also dealt with him in my capacity as a public representative in the other House when I was trying to make a case for children with scoliosis. I always found him to be a very straight man, a very good man and somebody who was spoken of extremely highly by all of those who dealt with him. I wish him well.

I cannot answer specifically about the 70 patients the Senator referred to but I will find out whether they will remain in the public system under the new consultant or whether it is intended to move them to the private system. I will get that information sent over to the Senator.

Denis O'Donovan (Fianna Fail)
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I thank the Minister of State and Senator Swanick. I hope progress can be achieved in that area.