Dáil Éireann Debate, Thursday - 9 November 2023
2. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) has stated that 312 children are awaiting scoliosis surgery, that surgery targets have not been met and that ongoing failures lead to life-long health complications; and if he will make a statement on the matter. [49192/23]
View answerMy question is about the waiting time for scoliosis surgery. The Scoliosis Advocacy Network has stated that more than 310 children are waiting for surgery at this time. That is completely unacceptable. I would like to hear the Minister's thoughts on the matter.
I thank the Deputy for raising this issue. I agree that the waiting times for scoliosis and spina bifida surgeries are not acceptable. I am conscious of the pain, suffering and anguish that are caused to the children and young adults who are waiting and to their families. For this reason, I committed €19 million in 2022 and 2023 to tackling these lists. Our goal is clear; it is to reduce the wait time for anyone for whom surgery is clinically appropriate to no more than four months. There is broad agreement on that target. That is why we invested the €19 million.
To date this has meant posts for an additional 193 healthcare professionals being funded across Temple Street, Crumlin and Cappagh hospitals, including nurses, consultant doctors, anaesthesiologists, radiographers and others. As the Deputy is aware, we are in the middle of bringing much more capacity online. Children's Health Ireland, CHI, has hired many more people and more surgery is taking place. Another wave of capacity is coming online, which includes a fifth operating theatre in Temple Street hospital, a second MRI machine in Crumlin hospital and 24 additional beds, of which 20 are already open and four more will come on stream shortly.
Last year, 509 spinal procedures were carried out, compared with 380 in 2019 before the Covid-19 pandemic. We have seen an important increase in the number of spinal surgeries. However, we have not seen a corresponding fall in the number of children on waiting lists. The clinicians have given us various reasons for that. Our focus now is to ensure the additional capacity is being used for what it was dedicated to, namely, paediatric orthopaedics and spinal surgeries, and that the increase in activity will result in what we all want to happen, which is a significant reduction in the number of children on waiting lists to the agreed levels.
That is positive but there are families with children who have been waiting for well over four months. That is completely unacceptable. The Minister's predecessor said six years ago that no child would wait more than four months. That promise has been broken many times. The Minister will understand that it is frustrating for people who have a child waiting for surgery that could be revolutionary for the child when that surgery does not happen. What the Minister said was all positive but the litmus test for families is the intervention and waiting times before their children can get surgery. It is clearly not happening quickly enough. Will the Minister reassure the families in question that surgery will happen as soon as possible?
I assure the Deputy, the House and, more important, the people who are waiting for the surgery and their families that a lot of activity is taking place. The resources are in place. The Taoiseach and I met advocacy groups recently. They put many important issues on the table. There is better engagement now. We are looking through a list of actions they asked to be looked at. The Deputy will be aware that Mr. Nayagam is doing an important review looking at some of the issues that have been raised. I have also asked him to come back with any recommendations for improving the service. At the same time, my Department and I are engaging with the HSE and CHI to ensure the changes needed to the current service are made quickly in order that children can get the care they need when they need it, which is what we all want.
I understand that the review by Mr. Nayagam is ongoing and that it is looking at the broad spectrum of ways to improve services. Is one of those - I am sure the Department has looked at this - for children to travel abroad for intervention or surgery? That can be slightly complicated given the nature of this surgery. Has it been actively looked at? It is good that we have more capacity but the test is whether children are waiting longer than they should for intervention, and they are. The Minister and his colleagues want to reduce the waiting time to as close as possible to the four-month target but that target is clearly being missed. As I said, 90 children have been waiting more than four months. This surgery is complicated. Has the possibility of children travelling abroad been looked at or have medical facilities where the surgery could take place been considered, other than the main hospitals in Temple Street, Crumlin and Cappagh?
The short answer is "Yes". Clinicians are cautious about that option. It happened before. Children went to Germany before the Covid-19 pandemic. Clinicians are not opposed to that but they urge caution because these surgeries tend not to be a single episode in a theatre. Ongoing care is required and multiple surgeries can be required. Nonetheless, we are looking at what is called outsourcing. A good relationship is being built between the Boston Children's Hospital and CHI. What they call insourcing is also being looked at, which means that rather than the children and their families having to go abroad, potentially several times, we would bring additional consultants and expertise to Ireland and use the capacity we have so they can get the service they need here.
