Seanad debates

Tuesday, 19 October 2021

Nithe i dtosach suíonna - Commencement Matters

Health Services

2:30 pm

Photo of Victor BoyhanVictor Boyhan (Independent)
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I thank the Minister of State, Deputy Feighan, and welcome him back to the Seanad. This issue relates to the Scoliosis Advocacy Network. I am not sure if the Minister of State has been briefed on this issue, but its representative appeared last week on "Today with Claire Byrne" on RTÉ. One of the reasons I am following up on this is that the Scoliosis Advocacy Network has been in touch with me, as it has been in touch with many other Members. The network's concern is what it describes as children languishing on waiting lists to have their medical needs and surgery addressed.

On "Today with Claire Byrne", the cofounder of the Scoliosis Advocacy Network, Ms Clare Cahill, said there had been no engagement with the Minister for Health, Deputy Stephen Donnelly, despite repeated requests. That surprised me. I have a lot of time for the Minister; he is most engaging. Any time I have had any reason to deal with him on any matter he has been prompt and responsive. That is on the record and I have checked it again. This story was covered on RTÉ radio. I checked again this morning just to be sure. The network has said it is a concern and I would like some clarification on that assertion.

The network has cited the last-minute cancellation of surgery, as well as the experience that some children have had of surgery being cancelled; many of them have had it cancelled three times. That is clearly unacceptable. We know that the Ombudsman for Children has highlighted access to scoliosis care for children and has spoken about it as being a fundamental children's right. I agree with him.

The HSE promised it would buy surgeries and provide health services through the private health system, in a similar manner to the National Treatment Purchase Fund, NTPF. I now understand this is not available for those with very complex needs, and I can understand that. That is fair and reasonable.

Two issues stood out in RTÉ's coverage of this issue. The Taoiseach has said that the delays in treatment are not because of the lack of resources, but rather are the result of a systemic failure. He said he has spoken to the Minister for Health about these matters. The Minister for Enterprise, Trade and Employment, Deputy Leo Varadkar, said the Government severely regrets that children and their families are experiencing long waiting times for scoliosis treatment and that he is seriously concerned about it. I think that is fair comment.

I had hoped to ask the Minister for Health about this. There are now 172 children waiting for scoliosis treatment, many of whom are, as their parents have described, in agony. They have specific needs and the longer interventions are delayed, the more impact there will be on them. It is a scandal. Health is an important issue. It is something that has to be addressed, in particular where children are concerned.

I am not sure if the Minister of State is in a position to answer my question, but I intended to ask the Minister for Health to explain why there is such a delay in surgery and what the systemic failure is that the Taoiseach is on the record as saying exists regarding scoliosis treatment. In a nutshell, I want the Minister of State, if he can, to set out a timeline for how these children will be treated and, more importantly, an absolute commitment that the Minister and Department of Health will engage in a meaningful way with the Scoliosis Advocacy Network.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for raising this very important issue. On behalf of the Minister, Deputy Donnelly, I welcome the opportunity to address the House.

I sincerely regret that children can experience a long waiting time for scoliosis treatment and I remain conscious of the burden this places on them and their families.The priority of the Minister for Health and the Government is to improve waiting times for all patients accessing hospital treatment, and reducing paediatric waiting lists for orthopaedic procedures remains a priority within that. The Department, the HSE and the National Treatment Purchase Fund, NTPF, are working on a multi-annual waiting list plan to address waiting lists and bring them in line with Sláintecare targets over the coming years. This process will be overseen by a ministerial task force, chaired by the Secretary General of the Department and including representatives from the HSE and the National Treatment Purchase Fund. It will take the learnings from the achievements of the vaccine task force to inform the plan.

To support the work of the task force, an additional €250 million is being provided in budget 2022 to improve access to care across the health system. It is recognised that waiting times for scheduled appointments and procedures have been impacted in the past 19 months as a direct result of the Covid-19 pandemic and, more recently, as a result of the ransomware attack. The cyberattack in May 2021 in particular caused significant disruption to the orthopaedic service and all services across the Children's Health Ireland, CHI, hospital group. Without access to a patient's full history and previous diagnostic investigations, it was not considered safe to proceed without all electronic support systems in place. This impacted patients with complex needs in particular and restricted the patient cohort that could safely proceed without surgery during this time. Most systems are now back up and running across CHI sites, but backloading of information is ongoing, and this continues to have an impact on waiting lists and the numbers of surgeries completed.

Despite the impact of the pandemic and the cyberattack, Children's Health Ireland advises that as of the end of September 2021, 266 spinal surgeries had been carried out, which is an increase of 41 compared with the same period last year. CHI has remained committed to increasing activity levels and examining innovative measures to improve access to all specialties. For example, additional theatre sessions are being held in Cappagh National Orthopaedic Hospital for non-complex, age-appropriate orthopaedic patients. CHI also continues to develop the advanced clinical triage model in Citywest. Active clinical triage is a system which has been adapted for use within the paediatric orthopaedic unit at CHI Crumlin. Its purpose is to reduce the overall orthopaedic outpatient waiting list, starting with the longest waiting clinically appropriate referrals.

A new orthopaedic consultant with a specialist interest in neuromuscular conditions started in Temple Street in September, which should also enable the use of additional theatre capacity and support additional capacity as part of the Cappagh kids programme. Officials in the Department of Health remain in regular contact with CHI regarding scoliosis services, and CHI has advised that all patients with a diagnosis of scoliosis require a preoperative work-up prior to spinal surgery, including multiple diagnostic investigations and a review by a multidisciplinary team. The plan of care, which is implemented for each patient, is tailored to best meet a patient's clinical requirements. It is the responsibility of the treating consultant to prioritise patients clinically on the waiting list for surgery.

Photo of Victor BoyhanVictor Boyhan (Independent)
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I am very disappointed. I do not know who prepared the Minister of State's response. This matter was specifically about scoliosis. This was not about the National Treatment Purchase Fund or waiting lists generally. This was a very focused Commencement matter about 170 children with scoliosis. It was as a result of an episode of "Today with Claire Byrne" on RTÉ last week and correspondence that had been sent to the Taoiseach, the Tánaiste, the Minister for Health and the leader of the Labour Party, Deputy Kelly. There is no comfort in the Minister of State's reply. What do I say when I pick up the phone in ten minutes' time to speak to the Scoliosis Advocacy Network, whose members asked me to make a case for them here today?

The reply does not talk about the systemic failure the Taoiseach spoke about and is on the record as having spoken about. It does not talk about the severe regrets expressed by the Tánaiste or children's experiences of long waiting lists or the need to remain conscious of the burdens that are placed on the families concerned. None of that is addressed in the Minister of State's response.I respect the Minister of State. He has a task to do and he is delivering the substance of this message on behalf of the Department but I ask him to go back to it and say this is urgent. It relates specifically to the 172 children who want to know when they are having their treatment. They do not want to hear, for the fourth time, that their treatment has been deferred. I thank the Minister of State for giving the Department’s response but I respectfully ask him to go back to the Department and say he is not happy with it. It is not comprehensive and it does not give comfort to the children and families involved.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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Again, I thank to Senator for raising this issue. I am acutely aware of the distress and inconvenience caused to patients and their families when urgent care is delayed. Improving waiting times for hospital appointments and procedures is a priority. I will relay the Senator’s concerns and annoyance to the Minister and the Department.

It is recognised that waiting times for all scheduled appointments and procedures have been impacted in the past 19 months as a direct result of Covid-19. There have been some positive aspects but the needs of the 172 young children need to be addressed as quickly as possible. I hope my officials in the Department will work closely with Children’s Health Ireland and the wider HSE to try to improve access to this treatment.

The Senator asked for a commitment to a timeline. I cannot give him one. However, I thank him for raising this difficult and important issue. I will relay his views to the Department and try to get him a response as quickly as possible.