David Cullinane (Waterford, Sinn Fein)
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81. To ask the Minister for Health his plans to deliver on commitments to persons with scoliosis and reduce wait times for care; and if he will make a statement on the matter. [23646/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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In recent years there has been an increased investment in paediatric orthopaedics and scoliosis services, which has improved access to surgery and outpatient appointments. In 2018 Children’s Health Ireland (CHI; previously the Children’s Hospital Group) was provided with an additional €9 million in funding to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. Scoliosis activity accounts for 20% of overall orthopaedic activity across CHI.

This funding supported the recruitment of approximately 60 WTE in 2018 and 2019 to enable the expansion of paediatric orthopaedic services including scoliosis services. The posts relate to the multi-disciplinary team at diagnosis, pre-assessment, during surgery in theatre, and post operatively. The majority of posts were allocated to each hospital in 2018.

The 2018 investment in paediatric orthopaedics included funding to support transition of adolescents with scoliosis from CHI at Crumlin to the Mater Misericordiae University Hospital (MMUH). CHI and MMUH have developed and agreed the clinical pathways for the transition of adolescents with scoliosis to MMUH. The transition of patients over the age of 16 who were awaiting a first-time outpatient/spinal review appointment at Crumlin commenced in December 2018. Each month, appropriate patients are identified for this pathway via clinical validation.

CHI have advised my Department that the introduction of government restrictions for COVID-19 based on public health advice required CHI at Crumlin and Temple Street to defer all non-emergency spinal operations. CHI at Crumlin and Temple Street have now resumed services on an incremental basis.

Key social distancing measures and Infection Prevention and Control (IPC) requirements have material impact on the available physical space to deliver services, significantly impacting on the overall capacity and operational activity levels for inpatient / outpatient settings. To the end of August 2020, 177 scoliosis procedures had taken place, compared to 251 for the same period last year, marking a decrease in activity of 29%.

At the end of August 2020 there were 218 scoliosis patients waiting for a spinal procedure at Crumlin, Temple Street and Cappagh Hospitals, across active, TCI (to come in) suspended and planned procedure categories. Of this number, 129 were awaiting spinal fusion procedures, while 89 were awaiting other spinal procedures.

Additional initiatives are being explored to increase access to scoliosis treatment - CHI is working with the National Orthopaedic Hospital, Cappagh to transfer additional patients who meet the clinical criteria for treatment at Cappagh and in conjunction with the NTPF, sourcing additional theatre space. 

Scoliosis services, waiting lists, and activity levels are specifically monitored by the Scheduled Care Performance Unit in my Department, through weekly performance monitoring meetings which are attended by representatives from CHI, and through continued engagement between Department and HSE officials.