Topical Issue Debate

Schools Building Projects Status

I wish to raise issues regarding Garranbane national school, Dungarvan, County Waterford. It is probably best if I just read out a letter I received from the school principal, signed on behalf of the school's board of management, because it best outlines the issues facing the school.

Dear Mr. Cullinane,

The Board of Management and the school community of Garranbane National School require your assistance in approaching the Department of Education [and the Minister] on our behalf, to request that they grant full funding for the development of a safe school at Garranbane.

On the 16th May 2012, under the Prefab Rental Replacement Scheme, Garranbane N.S. received a grant for a standalone extension consisting of 4 x 80m2, 2 x 25m2 and 2 x 16m2 permanent rooms. Since then there has been several setbacks in proceeding with this build.

Initially Waterford County Council refused planning, this was as a result of objections lodged. An Bord Pleanála finally granted conditional planning permission to the school in 2013. The total cost of the project [...] is proposed to be €1,385,769.16. This greatly exceeds the Department of Education approved funding. The overrun in costs is due solely to the imposition of the conditions as set out by An Bord Pleanála.

The total funding approved [...] is €718,226.00 [which means the shortfall] is €667,543.16.

The BOM, staff and parents are very concerned, as in four years there has been no progress on the build and to date we have not received funding. We are situated in a unique hazardous unsuitable site for any school, on the fork of a road on a hillside between the N25 and a narrow local road the site of many traffic collisions. Our school currently presents numerous health and safety issues.

- In June 2014, the school was informed that there were major exceedances of lead in the water supply, even after a five minutes' flush. As it was the BOM belief that major work was soon to begin on the school, an external temporary drinking water tap was installed on the school grounds and no other structural work was done to the pipes. This single tap provides the only drinkable water on the school grounds for a population of more than 200.

- Asbestos hazards were found present throughout our school, in a report published in 2003, thus warning signs are posted throughout the school [...]

- The main building was built in 1939 containing two classrooms. The enrolment at that time was approximately 100 pupils, our current enrolment is 196 [...]

- The sewage system that was installed at that time does not function adequately to cope with the increase in enrolment [...]

- Several of our prefabs have leaks in the roofs and mould, mildew and mushrooms growing around the corners of ceilings. They are draughty and cold in winter and overheat in summer and yet children are expected to work in these conditions.

- One of the larger prefabs has several holes in the floor, where the floor has collapsed and which has had to be patched up temporarily to avoid injury.

- The staffroom catering for 14 adults and visitors is a converted cloakroom, extended in 2004 by the Board of Management.

- There are no cloakroom facilities in the main building. All coats are kept in small classrooms which makes movement around classrooms limited with such large pupil numbers, causing dampness/mildew, again [...] unsatisfactory for all children but especially those with asthma/chest conditions.

- Toilet facilities are inadequate and out-dated. In the main building 6 toilets cater for 100 children. Continuous problems with blockages [...]

- The school is not accessible by wheelchair.

- All footpaths, playgrounds and pavements are cracked and broken [...]

- The school is situated on a hillside and the forty-two steps up to school have no hand rails presenting a safety issue for all school users especially special needs children.

The Minister will be able to understand from the letter all the problems with which the school must deal daily. I am sure he would not want it thought that any of them-----

Tá an t-am caite.

-----relates to him in such circumstances.

We will not have time for the response.

I ask the Minister to outline the situation.

I thank Deputy Cullinane for raising this issue. He is absolutely right that this project has had a very troubled history. I have had discussions with his constituency colleague and my ministerial colleague, Deputy John Halligan, about the situation. The school was selected for inclusion in the Department's prefab replacement scheme in 2012, as Deputy Cullinane said. The approval was for four mainstream classrooms and four ancillary spaces to be delivered by way of a stand-alone structure on the site. The commensurate level of funding for a project of this scale was sanctioned.

The project was devolved for delivery to the board of management, which appointed a consultant to design and deliver the project. This was therefore a devolved project intended to speed up the process but, as the Deputy knows, the difficulties then ensued. A critical role for the school authority in a devolved building project is to ensure both adherence to the scope of the approved work and the cost control for the approved spend. Failure in either area inevitably leads to delays. External matters outside the board of management's control, such as the need to obtain planning permission and all that this may entail, will also impact the timelines for delivery of the project, which is exactly what happened in this case.

While there were issues with adherence to the approved scope of the works, the planning permission process was particularly difficult due to the nature of the site and with traffic management issues on and extraneous to the site. This resulted in at least one request for further information from the local authority to the board of management that the Department is aware of. Overall, this process took much longer than is usual and further difficulties were to ensue in that the planning permission granted was subsequently appealed to an An Bord Pleanála by third parties.

An Bord Pleanála eventually granted planning permission but attached onerous planning conditions to a range of issues including site works, traffic management, pick-up and set-down areas, car parking, etc. The school's proposals to deal with these issues were to be agreed with the local authority before the project could proceed. This involved another piece of significant work for the project. For example, another range of surveys were required to be carried out on the site such as geo-technical surveys, the cost of which were met by the Department. Interactions were also necessary with the local authority to develop and agree the proposals.

When proposals were ultimately agreed with the local authority, the cost estimate for the project almost doubled from the original cost approval. Accordingly, the Department sought details of the proposals in question and spent some time obtaining satisfactory explanations. In the meantime, the school tendered the project, seeking additional funding based on the tenders received. In the absence of satisfactory responses to the cost escalation, the Department was not in a position to approve the funding uplift. That tender process is now out of time under public procurement procedures and is defunct.

Having received satisfactory explanations for the cost overrun in more recent times, the Department is now prepared to allow the project to be retendered and it has informed the school of this in writing, with clear instructions on how to properly complete the process and the junctures at which it must interact with the Department throughout the process to ensure that it runs smoothly.

The matter is now in the hands of the school. The Department is committed to the delivery of the project and strongly urges the board of management to focus its energies and resources on putting the retendering process in train as quickly as possible so that the project can go to site as early as possible in the new year.

In the intervening period, the school may apply for emergency works funding to deal with any access issues it might have at the school, provided this work will not be aborted when the main project is delivered. This is a matter for the board to discuss with its consultant, bearing in mind that the rate and pace of delivery of a large-scale project for the school rests firmly with the board of management.

I welcome the Minister's reply. I wonder about the timelines involved. I received this letter from the school on 12 December, and it does not mention that the Department got back in contact with the school to let it know that it could re-tender. Maybe this happened after that date. I will refer back to the school to find out, but contact would be welcome. I assume this would still cause a delay, but the question then is the difference between the actual cost and the initial cost. Is the Minister saying that when a school retenders, it can now do so for the actual cost of carrying out the works, which I think is €600,000 more in this case?

Is that the position? I am seeking clarity on that point.

I do not have the exact date on which the school was informed, but on 24 November the Department was satisfied that the information on the scope of the works outlined was necessary and it was in a position to re-tender. I am unsure what time elapsed after that until the school was notified.

The Department has excluded nothing from the scope of the works being re-tendered for. The scope is the same as for the original works. Obviously, as the tender proceeds, the Department will have to be satisfied with the way in which the tendering process is being conducted and so on, as I outlined in my earlier reply. However, nothing has been deleted from the project that would undermine its value to the school community.

School Staff

According to figures from the Irish National Teachers Organisation this morning, only 36 substitute teachers were available nationally on its SubSearch facility today. This compares with an average daily total of 400 in previous years. Today's figures would not cater for the necessary cover for Tallaght, let alone the whole country.

The shortage of substitute teachers has been a matter of grave concern to principals throughout the country since the October mid-term break as well as to teachers. Indeed, we now have teachers offering to come in under the weather, as it were, rather than having a class broken up and distributed among the other classes in the school. This poses particular difficulties for teachers in one, two and three-teacher schools. It is especially difficult in smaller towns and cities and rural areas. It is a serious headache for principals.

One principal described the situation to me. She said that recently she had three sick colleagues and another was on a pre-arranged course day. All three absent teachers were on certified sick leave. She made more than 20 calls to her own personal list of substitutes but no one was available. She eventually sourced a teacher through the INTO SubSearch facility, but that teacher was on her way to a medical appointment with a sick parent. No substitutes were available through the Irish Primary Principals Network TextaSub facility. This resulted in two of the classes being distributed throughout the school, with one class having 39 children for the day. She also had to use two learning support staff members to cover these classes on the day, resulting in potential disruption to children with special educational needs. That principal set out clearly the difficulties the lack of substitution arrangements or facilities can have for people.

The shortage of substitutes is having a serious impact on teaching principals as they are increasingly unable to avail of the principal release days. Such days are vital to them for administrative and leadership planning roles in their schools. This is a consequence of the lack of substitute cover. It is also impacting on the ability of teachers to participate in continuing professional development for the same reason.

There is a real danger that the substitute shortage will quickly have an impact on learning outcomes. We are all rather proud of the OECD programme for international student assessment report and the standings published earlier this week. They show that we have improved to become the third-best performing nation in the world in terms of reading. This move was initiated by my now retired colleague, the former Minister for Education and Skills, Ruairí Quinn. Classes of up to 40 children on a regular basis will rapidly undermine this progress.

The reality is that the current situation is directly related to the issue of pay equalisation. Teachers are being actively recruited by Middle Eastern countries, even from the teacher education sections of our universities. Teachers from large urban areas are especially concerned at the high cost of living in comparison with their now reduced pay. Like staff in the medical sector, we are now in danger of losing a generation of teachers who have been educated at considerable expense to taxpayers.

The Minister urgently needs to consider the establishment of a national and regional supply panel, such as those in operation in other countries. This would give substitute teachers and schools some degree of certainty in respect of their positions. I am keen to hear the response of the Minister.

I am aware that some schools are experiencing difficulty in recruiting adequately qualified substitute teachers. I am committed to examining all possible means of addressing that issue. In overall terms, however, the Department has no evidence of a recent or current shortage of primary teachers. There are many different variables that affect the supply and demand for teachers in our schools, such as the number of new graduates, the number of retirees, Government policy on the pupil-teacher ratio and so on. Deputy Burton is aware of these factors.

In 2015, a one-year reduction in the number of newly qualified teachers graduating from the higher education institutions materialised due to the reconfiguration and extension of the programme of initial teacher education from three to four years. This may have contributed to a reduction in the supply of teachers at primary level. A little over 3,500 graduate teachers registered with the Teaching Council last summer. Another important factor to take into account in this area is that the entire thrust of policy under the previous Government, in particular the relevant Ministers at the time, Mr. Quinn and Deputy O'Sullivan, was to ensure that to the greatest extent possible young teachers at the start of their careers, including unemployed teachers, were given priority when it came to recruiting substitute teachers. Obviously, that is putting some pressure on supply. In recent years, with the improving economic environment, we have been able to step up the pace of recruitment of teachers. This September we recruited 2,260 new teachers. Next September we intend to recruit 2,400, more than double the number possible in recent years.

The Department considers it important that the supply of teachers with the required qualifications is adequate to meet demand at primary and post-primary level. The Teaching Council Act gives a specific statutory role to the Teaching Council to advise in that respect. The council has been asked to consider the matter of teaching supply. The council has set up a technical working group. The working group is examining a series of issues. The aims of the working group include developing and piloting a model of teacher supply that would seek to ensure a sufficient supply of teachers to meet demand; formulating advice on teacher supply for consideration by the Teaching Council; considering the analysis of data held by the council and the Department in developing the pilot model of teacher supply; and generating policy recommendations on teacher supply for consideration by the Teaching Council. In parallel with that reform, the relevant education stakeholders were consulted regarding the emerging recommendations during the process. Feedback from this group was considered by the working group in its deliberations and in the development of the final report. I expect the report to be published in due course. The report includes recommendations specific to the supply of teachers. I expect the Department to be in a position to progress consideration of the report in the near future.

I will specifically ask that the issue of substitute supply be examined in that context because of emerging difficulties. We will look at various suggestions that might ease the short-term pressure.

The question of whether a panel will be established was put forward. At the moment there is a good network that uses rapid website communication. As the Deputy rightly pointed out, it is not always successful. Whether the Department could improve on that would be an issue that would have to be considered.

I thank the Minister for his reply. A sense of urgency and an acceptance that this is a problem is required. It is a disturbing issue for school principals and management. It is especially difficult if a number of teachers become sick or if, in the longer term, a number of staff become pregnant and require maternity leave. The INTO has been looking for a national and regional supply panel. Such a facility would have to operate regionally with the use of social media or some other information technology-based contact base. It is possible to have a rapid flow of information to and from school principals to the panel in their area. The problem is especially acute in smaller schools where there is a teaching principal, as opposed to an administrative principal in a larger school where that principal does not have to teach as well.

There are real problems in such schools if one or more of the teachers is missing. While it can be exciting for kids for a day or two when two classes are put together, the kind of uncertainty this generates is not great from an educational planning perspective. In fact, it can be a sign of the total absence of planning. I appreciate that the Minister is in the hands of the Teaching Council to some extent. I am disappointed by the slow development of the final report which the Minister has said he expects "to be published in due course". Would it be possible to put a timeframe on this? The Minister is famous for action plans. As we approach Christmas, can we have an action plan that will see regional and supply panels established by the end of January? It is not a difficult principle. I expect the Minister to respond to it positively.

The Teaching Council is considering the longer-term issue of the future supply of all teachers, including substitute teachers. I accept that the restrictions which have been imposed on the recruitment of retired teachers could be re-examined as a short-term measure. There would have to be an assessment of whether a panel would work. Short-term opportunities tend to arise in this area at short notice. The question of whether any panel can facilitate an instant response will have to be considered. There are good websites that are often very successful, but at times there can be restrictions on local availability due to the nature of the positions on offer. There is a genuine difficulty in this respect. I will have a look at this issue, but I do not want to commit to having a solution when there is no immediate path here. We will assess what can be done. We will look at the various suggestions that have been made, including Deputy Burton's suggestion with regard to the INTO and the suggestions that have been made by management bodies, to see whether we can respond more effectively.

Road Improvement Schemes

The serious difficulties that exist on the N24 between Mooncoin and Carrick-on-Suir were highlighted at a meeting in Piltown community centre on Monday night which was attended by 500 local people from the surrounding areas. All of the people who attended the meeting, which was organised by the local priest, Fr. Moore, and a community activist, Robert Duggan, are interested in restoring safety along this stretch of roadway. There were ten white crosses behind the backs of those who addressed the packed audience at the meeting from the main table. Fr. Moore referred to the roadway in question as the "valley of death". When this road was being designed and constructed between 1995 and 2002, when it opened, there were constant difficulties with the National Roads Authority, NRA, as it was at the time, and the engineer on the project. Those who raised matters with regard to the road, including the local radio station, were often challenged legally so that they would stop doing so. This happened to me as a member of the local council at the time. To this day, nobody has officially opened the road. Everyone in this House knows that when money is spent on a road, some politician will cut the tape. I have nothing against that. Even though this road was funded through the NRA, it is the road that nobody wanted.

Every effort to get the NRA, and now Transport Infrastructure Ireland, TII, and the Department of Transport, Tourism and Sport to look at the road has failed. Money was allocated for an overpass on this stretch of road in 2012. Everyone has been demanding such an overpass since the road was originally designed, but those responsible have still not given in and provided it, despite many deaths and numerous accidents. Most of the accidents on this stretch of road are recorded by the local gardaí, but others are not even reported. This notorious piece of road, where two roads go into one, is the worst piece of engineering one will ever see. The firm line of wire going down the centre of the road is a danger to motorcyclists and pedestrians, as we heard the other night. Local people and others who want to travel in a certain direction on the road have to travel in the opposite direction so that they can turn back. It is unbelievable that such a road was funded and constructed by the NRA. If the NRA had taken account of the issues it ignored at that time, we would have a different, safer road now. It was only when a local farmer, Donal Norris, drove his cattle down this road that the NRA was forced to provide a safe underpass. He should not have had to encounter such difficulties as he sought to achieve his rights. It was absolutely shocking that he was treated in such a way by a State agency.

We are looking to the future now. We are asking for a complete redesign of the roadway in question. The redesign must take account of every single turn off the roadway and every single safety issue that has been raised with regard to it. We are asking for funding to be made available immediately in order that overpasses can be provided and the necessary work can be done.

I thank the Deputy for observing the time limits.

I thank Deputy McGuinness for raising this important Topical Issue matter. As he knows, I will meet Deputies from the area in question tomorrow. This is a matter that concerns them all. I know the Deputy has raised it on their behalf today. Before I refer to the scripted reply, I think it is reasonable for me to say that the Deputy has made a fairly compelling case. I intend to tell the Deputies at tomorrow's meeting that I am planning to ask Transport Infrastructure Ireland, TII, to respond to them and to report to me on this road purely in terms of safety. I think that is the case Deputy McGuinness has made. I hear many pleas for roads projects on Topical Issue matters, but it is unusual for me to hear such a compelling case from a safety perspective. If the statistics mentioned by the Deputy are right, and they may well be, I think this should be looked at. There is no adequate answer when there are road deaths, or when there is a lack of road safety. Perhaps the road is not as bad as the Deputy has suggested, but if it is that bad, he deserves to get a serious and considered response.

As Minister for Transport, Tourism and Sport, I am responsible for overall policy and funding in relation to the national roads programme. The planning, design and implementation of individual national road projects is a matter for TII under the Roads Acts 1993 to 2015 in conjunction with the local authorities concerned. The assessment and prioritisation of individual projects are matters for TII in the first instance, within its capital budget, in accordance with section 19 of the Roads Act 1993. Therefore, decisions relating to the N24 are operational matters for TII. As I have said, I will ask TII for a direct response to what the Deputy has had to say. The capital plan that was published in September 2015 outlined the Government's proposed transport investment priorities to 2022. The transport element of the plan was framed by the conclusions reached in my Department’s strategic investment framework for land transport. This report highlighted the importance of maintaining and renewing transport infrastructure and making targeted investments to address particular bottlenecks and critical safety issues. The capital plan provides €6 billion for investment in the roads network in the period to 2022, with €4.4 billion earmarked for the maintenance and strengthening of the existing extensive network throughout the country and €1.6 billion earmarked for new projects.

Allowing for the commitments relating to public private partnership projects, the balance available for new projects within the available capital envelope is limited. As Minister, I have to work within the annual allocations set out in the plan. In this context, the capital plan provides for a gradual build-up in capital funding from the current relatively low base towards the levels needed to support maintenance and improvement works. It will take some years under the capital plan to restore steady-state funding levels for land transport. There will have to continue to be a focus on the maintenance and renewal of infrastructure. There will be a significant ramp-up in funding from 2020. This will facilitate the construction of the road improvement projects included in the plan.

While available funding is not sufficient to address all the demands for improvement schemes, including schemes such as the upgrade of the N24, by the end of the plan period, I expect that capital funding for the road network will be back up to the levels needed to support maintenance and improvement works in the future. On the possibility of additional funding within the plan period, the Minister for Public Expenditure and Reform indicated in his budget speech that he is bringing forward the capital plan review. There is a strong case for additional funding for the transport sector, which I will make robustly.

I must interrupt. I call Deputy McGuinness.

Again, the reason for raising this issue is not because it has just arisen. This is an issue that has gone on since 1995, right through the course of the design and building of the road in question. It is so dangerous that, as I said, 500 people attended the meeting that was held. I am asking the Minister whether he will come and examine that stretch of roadway. In a contribution made earlier by the Minister for Children and Youth Affairs, Deputy Zappone, in respect of a parliamentary question, she said that she indicates her priorities to Tusla. I am asking the Minister, Deputy Ross, in the context of his priorities, which are safety on our roads and representation for local communities, whether he will agree to say to Transport Infrastructure Ireland that he wants the funds allocated to this project.

Before he does that, will he come to visit the stretch of roadway involved so he can see for himself the plight of the local community and the desperate need for the road to be redesigned? It is not good enough to have an analysis or a report. We know what has happened. The Minister should listen to the local community and respond to it by ensuring that safety is restored by investment in the road. These are local people who use the road every day going to school or to work in Clonmel and Carrick-on-Suir, as well as others who use it by way of connection along the route.

The money was there for an overpass and it was emphasised at the meeting to which I refer that had that money been spent when it was allocated in 2012, it would have relieved some of the issues. Two overpasses are needed. A new, modern, safe approach to the design of that road would eliminate the issues confronting this local community and people in the surrounding areas once and for all.

I am aware that there was a recent accident at Tower Hill junction between Piltown and Fiddown. This junction was the subject of an accident improvement project a number of years ago and the safety section of Transport Infrastructure Ireland is, as the Deputy knows, reviewing the junction in conjunction with the county council to see if further improvements can be implemented.

We do need answers, if what the Deputy says is correct. Safety is obviously a top priority and it comes above improvements in the roads. It is imperative that we address this matter. I take the Deputy's point. I hope he will accept that I will certainly ensure that Transport Infrastructure Ireland reports to me as soon as possible on what he has said about safety, because that is something which has to go to the top of the pile before road improvements.

As to whether I will come down to Kilkenny and have a look, I have known the Deputy for a very long time and this is the first occasion on which he has ever invited me down to Kilkenny, which is-----

It is the second.

Deputy Ross is the Minister now.

I am sure that has something to do with it. I find it extremely flattering that he would ask me to do so and I see absolutely no reason why I should not come down. If it is anywhere near the Tipperary border, I will nip over and see Deputy Mattie McGrath as well, who is also happy down there.

If there is a safety issue, it is important that it is addressed by a Minister. I will look at what Transport Infrastructure Ireland has to say and at the statistics in order to see whether they are consistent with what the Deputy says. If that is the case, I will be delighted to come to visit the Deputy in Kilkenny and have a look at the road to which he refers, which extends beyond his own constituency's boundaries.

I thank the Minister.

Hospital Services

I thank the Chair for selecting this very important matter for discussion. I am disappointed that the senior Minister is not here but I welcome the Minister of State, Deputy Catherine Byrne.

In mid-November, the Fianna Fáil spokesperson on health, Deputy Kelleher, made two impassioned speeches in this House following a meeting with members of the Scoliosis Advocacy Network who are campaigning very actively on behalf of their children and other children. Deputy Kelleher read a number of case studies into the record of the House and I want to update the Minister of State on one of them. Mary, whose name has been changed to protect her identity, was diagnosed at age ten in May 2013 with a 40° spinal curve at Mullingar General Hospital. She was referred to Our Lady's Children's Hospital Crumlin for urgent review by a specialist. She was obliged to wait 11 months before she could see a consultant. During this 11-month wait, Mary's curve deteriorated from 40° to 90°. At that point, she required urgent surgery to halt the progress of her spinal curve. In fact, she required two significantly invasive surgeries and would need to have some of her ribs removed. This was due to the long wait and the deterioration in her condition. She finally made it to theatre 17 months after her diagnosis for her first surgery and her curve was well over 100° at that point. Unfortunately, Mary now finds herself back on a waiting list for surgery to correct a failed fusion and there is no date in sight for this procedure.

Last week the Kilkenny scoliosis advocacy group wrote to update me on Mary's case and explained the following:

The pin which had become dislodged months ago has now moved and become septic. This child should not have been left wait months and months for this surgery. The fact is that the only way our children can access surgery is when they are in fact in a health crisis. This is shameful and of course we will be highlighting it with Minister Simon Harris. Before I left Our Lady's Children's Hospital Crumlin with my son after his surgery, I was told if a rod breaks or dislodges its ok. Don't present to Our Lady's Children's Hospital but go to a GP. This advice is totally unacceptable but indicative of the service our children are receiving. There has been a normalisation and acceptance of poor care and after care by teams involved in our children's care.

I am not going to stand in the House today and play politics with this issue but I have promised these women face to face that I will continue to raise these issues on their behalf. I understand the Minister has visited many hospitals around the country since taking over a very difficult brief, and that he is taking on his Ministry with determination and vigour, which is encouraging. However, these women are acutely aware of the current situation facing those on scoliosis waiting lists and this is a very damning assessment.

I acknowledge that commitments have been made for new theatres in Crumlin but the crux of the issue is that the longer we wait for policies to be implemented, the more children will be subjected to severe, long-term and, in some cases, irreparable damage while they wait. July 2017 has been stated as a timeline for the recruitment of additional consultants and for various policies to be implemented but we must be able to speed up this process. I have also heard statements about the difficulties surrounding recruitment but we must implement a more imaginative approach to attracting staff, particularly theatre nurses, on a short-term basis for these specific cases. We could recruit paediatric theatre nurses and additional consultants for several months to ensure extra capacity in the theatres in Crumlin to address this issue.

I am interested in hearing the Minister of State's thoughts on this potential strategy and I would like to ask her what progress has been made in reducing waiting times since we raised these issues one month ago.

I thank Deputy Aylward for raising this matter. I am pleased to take this opportunity to update the House on scoliosis services. Long waiting times for scoliosis surgery are not acceptable, and the Department is working closely with the Health Service Executive, HSE, to address services pressures, particularly in Our Lady's Children's Hospital Crumlin, which is the largest provider of scoliosis surgery for children and young people.

Additional funding of €1.042 million was allocated under the 2015 service plan to increase capacity at Crumlin, and further resources of €0.987 million were allocated under the 2016 service plan for orthopaedics and trauma to address service needs in Crumlin. The HSE is actively working with the hospital to advance the development of orthopaedic services, including spinal surgery services, which will have a positive effect on access for scoliosis patients. All patients on the waiting list are clinically triaged by a consultant as to their acuity and surgeries are carried out in order of clinical priority and waiting time, in order to provide an equitable service.

The number of consultant orthopaedic surgeons at Crumlin has increased by 1.5 whole time equivalents. The construction of a new orthopaedic theatre in Crumlin has been completed. This new facility will provide capacity for additional scoliosis activity in 2017. However, the use of this theatre is dependent on the recruitment of additional theatre nurses. While the hospital continues to successfully recruit nursing staff, balancing this with attrition rates, maternity leave and sick leave continues to present a challenge. The Children's Hospital Group is exhausting every recruitment and retention avenue available to it, including international recruitment, and is proactively working on nurse recruitment to support the opening of the new theatre.

In order to improve access in the short term, the HSE winter initiative 2016-17 includes €2 million provided specifically for surgery for scoliosis patients. To date under this initiative, 54 patients have been treated, have received appointments for treatment or been removed from the waiting list through clinical validation. This includes nine additional patients who have had their surgery at Crumlin and eight who have been given treatment dates. In addition, 23 patients have had surgery, or are scheduled for surgery, at Blackrock Clinic. Crumlin is continuing to work through a capacity plan to schedule patients that do not meet the age and clinical criteria for surgery in another hospital.

In an effort to address inpatient and outpatient spinal orthopaedic waiting lists at Tallaght hospital, an additional half-time consultant was appointed in late 2014. In 2015, some €1 million was provided by the HSE to fund 100 degenerate spinal surgeries at Tallaght. An additional consultant is due to also start work at the hospital in July 2017.

The Department will continue to work with the HSE and the relevant hospitals to ensure improvements in access to spinal surgery. The Children's Hospital Group is engaging with the scoliosis advocacy groups on developing a partnership approach to the design and planning of services for children with scoliosis. This provides an opportunity for them to work with hospitals and consultants in the design and planning of paediatric scoliosis services.

I thank the Minister of State for her response and I hope she will appreciate that I am not trying to be political in any way, shape or form on this particular issue but we must do everything we can in the coming weeks and months to shorten these waiting lists. These children and their families are enduring too much pain and suffering as a result of the current waiting times and I urge the Minister of State and top officials in the Department to approach this issue with all of their ability and innovative thinking.

We have to get creative. This is life-changing surgery and access to the surgery is the crux of this issue. We must get the theatres adequately staffed to increase the capacity and reduce the waiting times. The longer we leave these children, the worse they get. They start off with a 10o or 20o degree of curve. If they are treated at that stage, it will save money on major surgery later on. More money should be put into early diagnosis and treatment for these children before the situation becomes critical. In Mary's case, she was left for 12 months and her curve went from 40o to 100o degrees before the surgery was carried out. If that child had been seen when the curve was at 40o, it would have saved a lot of money for the State and a lot of pain for the child. Many children are coming into the system and there is a waiting list, although I do not have the figure here. I got it from the advocacy group. I ask the Minister of State to do everything she can to take these children in early and have them seen to early so that the curves in their spines will not get too serious before they are treated.

Speaking personally, as a mother and a grandmother, no child should be left waiting for surgery for such a long time. Unfortunately, as the Deputy knows, in the past matters were not as fluid as we would have liked them to be, but funding is now beginning to build up again and the Minister is doing his utmost to ensure that staff are provided. The HSE has tried to recruit people, especially in specialties around paediatric orthopaedic services and theatre nurses. We are trying to face this challenge together. I am delighted that the Minister has engaged with the parents' advocacy group. I will relay the Deputy's wealth of understanding of this serious situation to him. Like any parent, I do not want to see any child suffer.

I hope we will be able to address this early in the new year. It is not that people have not tried but that the staff has not been there to facilitate the opening of the new theatre in Crumlin. As somebody who lives quite close to the hospital, I know the wonderful work done there on a daily basis for young and older children.