David Cullinane (Waterford, Sinn Fein)
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998. To ask the Minister for Health the number of children waiting on a first appointment with an orthopaedic surgeon in Children's Health Ireland and other hospitals across the HSE in tabular form; the length of wait for each child; and if he will make a statement on the matter. [1335/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the COVID-19 pandemic.

Further to the deferral of most routine scheduled care activity in March, April, and May of last year due to the pandemic, the HSE is currently recommending that only critical time dependent elective procedures are undertaken at this time due to the on-going and significant increased demand for bed capacity related to Covid-19.

This decision was made arising from the rapid increase in Covid-19 admissions and to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols. 

In relation to the information requested by the Deputy, the attached spreadsheet outlines the number of children awaiting a first appointment with an orthopaedic surgeon in Children’s Health Ireland and other hospitals across the HSE in tabular form.

In the Irish health system, patients are generally referred for children’s hospital services up to the eve of their 16th birthday, however, there are exceptions. The NTPF classify children/adults as follows:

- Child only hospitals - all patients are classed as children, regardless of age.

- Adult only hospitals - all patients are classed as adults, regardless of age.

- Adult and Child Hospitals - patients under the age of 16 are classed as children, all other patients are classed as adults.

David Cullinane (Waterford, Sinn Fein)
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999. To ask the Minister for Health the number of children currently waiting on scoliosis surgery in Children's Health Ireland, Cappagh and the Mater in tabular form; the length of wait for each child and category of wait list, including all categories, that is, active, to come in, suspended and planned procedure; and if he will make a statement on the matter. [1336/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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Improving waiting times for hospital appointments and procedures, including scoliosis services, remains a priority of Government. Despite the challenges resulting from the Covid-19 pandemic last year, by 31 December 2020 Children’s Health Ireland (CHI) had carried out 322 scoliosis procedures, 163 of which were spinal fusions, and 159 other spinal procedures. Overall, scoliosis activity figures for 2020 were 16% lower than in the previous year, despite significant social distancing measures and Infection Prevention and Control requirements.

Scoliosis activity accounts for 20% of overall orthopaedic activity across CHI. 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.

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 multidisciplinary team at diagnosis, pre-assessment, during surgery in theatre, and post operatively. The majority of posts were allocated to each hospital in 2018.

On 2 January 2021, the HSE issued correspondence to the Acute hospital system advising of the need to curtail scheduled elective care. This decision was made arising from the rapid increase in Covid-19 admissions and the projected trend in admissions based upon community transmission levels of Covid-19. CHI has advised that under the current HSE guidelines, they have reduced the number of procedures to urgent and those that are time sensitive rather than a blanket cessation of all activity as was done in March/April last year.

CHI have confirmed that urgent Outpatient appointments continue to be held face to face, while some routine appointments have been deferred. Many specialties have switched to virtual appointments with some blended face to face appointments where deemed appropriate.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols. The HSE have confirmed that this position will be reviewed weekly throughout January.

Key social distancing measures and Infection Prevention and Control requirements, such as the current two-metre distancing, have had a material impact on the available physical space to deliver services, including scoliosis procedures. However, Children’s Health Ireland have confirmed that time dependent and urgent procedures will continue to be undertaken in CHI.

In relation to the specific query raised regarding the number of children currently waiting on scoliosis surgery in Children’s Health Ireland, Cappagh and the Mater, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.