I must now deal with a postponed division relating to the motion regarding paediatric orthopaedic and urology services. On Tuesday, 20 February 2024, on the question, "That the amendment to the motion be agreed to", a division was claimed and in accordance with Standing Order 80(2), that division must be taken now.
Paediatric Orthopaedic and Urology Services: Motion (Resumed) [Private Members]
The following motion was moved by Deputy David Cullinane on Tuesday, 20 February 2024:
That Dáil Éireann:
notes that, as of 13th February, 2024, there are 327 children listed as waiting on a scoliosis-related surgery with Children's Health Ireland (CHI), as compared to 312 in February 2017;
recalls the commitment given by the then Minister for Health, Simon Harris TD, in March 2017 that no child would wait more than four months for spinal surgery by the end of that year;
further notes that:
— 78 per cent of children are waiting longer than the Sláintecare target time for a paediatric orthopaedic inpatient appointment with CHI, and 81 per cent are waiting longer than the target time for paediatric urology;
— 84 per cent of children are waiting longer than the Sláintecare target time for a paediatric orthopaedic outpatient appointment with CHI, and 72 per cent are waiting longer than the target time for paediatric urology; and
— there is still uncertainty regarding the timeline for the transfer of services to the new Children's Hospital from the various Children's Health Ireland sites, and there are major concerns that a vast majority of children currently waiting for care will age out of paediatrics untreated;
expresses concern that:
— additional resources were made available to CHI to improve paediatric orthopaedic services, but members of the Oireachtas, members of the Government, patient advocates, and clinicians have expressed significant concerns regarding the use, extent, and effectiveness of this funding; and
— spinal surgical activity at CHI has been impacted by the voluntary leave of a consultant following significant concerns regarding return to surgery rates, infection rates, and allegations of inappropriate implantations at CHI Temple Street, the matters of which are subject to numerous reviews;
acknowledges:
— that the position of patient advocates is that existing reviews into CHI paediatric orthopaedic services are insufficient, too narrow in scope, and unlikely to have a satisfactory impact or reveal the true extent of the problem;
— the letter sent by the Minister for Health to patient advocates dated 6th February, 2024, which states that a paediatric spinal surgery unit will be established within Children's Health Ireland, that a lead has been appointed, and that the Minister "would like to convene a Taskforce"; and
— that the position of patient advocates is that a comprehensive, transparent, structured programme of work should be carried out by an independent taskforce, to include a comprehensive examination of the range of services related to scoliosis and spina bifida, care pathways, health care infrastructure, and the related governance of CHI;
considers that the Government has failed to deliver on its health and social care commitments to children, and that children's health care services are not operating at a satisfactory level as evidenced in the Sláintecare waiting list metrics;
demands that these systemic and historical failures are not allowed to continue as children deserve better; and
calls on the Government to:
— establish a taskforce which is independent of CHI management, which will be mandated to listen, engage, and act on the advice and concerns of parents, patient advocates, and clinicians, and include these stakeholders in its reporting process;
— mandate the independent taskforce to conduct a comprehensive review of scoliosis and spina bifida services, including transitional care, post-surgical specialist rehabilitation, and full and appropriate access to community services;
— deliver equitable and quality access to care that is evidence-based and in line with international best practice;
— ensure access to children's health services and treatments is provided on the basis of clinical need and not ability to pay;
— establish a sustainable public model of delivering specialist care for children with scoliosis and/or spina bifida, with increased public provision of care and a reduced reliance on private providers;
— make best use of international service options where clinically appropriate, and provide a wraparound care package for children and their parents/guardians, to include follow-up care post-operatively in Ireland as this is the main barrier for travelling abroad for children who can travel;
— resource and expand the paediatric orthopaedic elective care centre at the National Orthopaedic Hospital Cappagh, including provision of paediatric critical care capacity to support complex surgeries and children deemed clinically complex;
— assess a suitable location for the provision of an elective paediatric urology service and deliver such a service; and
— establish a permanent engagement process with patient advocacy and parent groups with lived experience, such as Spina Bifida Hydrocephalus Paediatric Advocacy Group and the Scoliosis Advocacy Network and others, at senior management level following the work of the taskforce.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
"recognises that:
— waiting lists for spinal surgery remain too long, despite an increase in the number of procedures carried out in recent years; and
— the Government is committed to improving the waiting time for children seeking care;
notes that:
— the Government allocated €19 million of current and capital funding to help tackle these waiting lists by creating additional capacity;
— the €19 million investment supported an increase in the number of spinal procedures undertaken by our healthcare workers in both 2022 and 2023;
— 509 spinal procedures were carried out in 2022, and in 2023 464 spinal procedures were carried out as compared to 380 in 2019; this represents a 34 per cent increase and a 22 per cent increase respectively compared to 2019;
— at the end of December 2023 there were 78 active patients waiting over four months, which is a 13 per cent reduction compared to the end of 2022; and there were 231 patients waiting for spinal procedures, excluding suspensions, which is a five per cent reduction compared to the end of 2022;
— this Government will continue to invest significant funding to help reduce the amount of time children are waiting for important hospital appointments and procedures;
— Scoliosis and Spina Bifida were identified as a priority area, one of three priority areas, in both the 2022 and 2023 Waiting List Action Plans; and
— Scoliosis and Spina Bifida services will remain as priority areas under the 2024 Waiting List Action Plan;
further notes that:
— the Minister for Health intends to convene a Taskforce and invited all patient groups to input into the Terms of Reference;
— a dedicated Paediatric Spinal Surgery Management Unit has been established in Children's Health Ireland, which is focusing on the management and delivery of spinal surgery, including increased activity and further reducing the waiting lists;
— a Clinical Speciality Lead for Spinal Surgery, a Nurse Manager, and Business Manager have all commenced in post;
— work is underway on a paediatric spinal care programme of work which involves actions to tackle the current waiting lists, the design and transition to a dedicated Paediatric Spinal Service, and outsourcing options for clinically suitable children; and
— this Government is committed to seeing the new Children's Hospital opened as soon as possible.".
- (Minister for Health)
Amendment put:
The Dáil divided: Tá, 71; Níl, 60; Staon, 0.
Tá
- Brophy, Colm.
- Browne, James.
- Bruton, Richard.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Byrne, Thomas.
- Cahill, Jackie.
- Calleary, Dara.
- Cannon, Ciarán.
- Carroll MacNeill, Jennifer.
- Chambers, Jack.
- Coveney, Simon.
- Cowen, Barry.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Donohoe, Paschal.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- English, Damien.
- Farrell, Alan.
- Feighan, Frankie.
- Flaherty, Joe.
- Fleming, Sean.
- Foley, Norma.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Heydon, Martin.
- Higgins, Emer.
- Humphreys, Heather.
- Lahart, John.
- Lawless, James.
- Leddin, Brian.
- Madigan, Josepha.
- Martin, Catherine.
- Martin, Micheál.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McGuinness, John.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Naughton, Hildegarde.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Connor, James.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Donovan, Patrick.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Rabbitte, Anne.
- Richmond, Neale.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Troy, Robert.
Níl
- Andrews, Chris.
- Bacik, Ivana.
- Barry, Mick.
- Berry, Cathal.
- Brady, John.
- Browne, Martin.
- Buckley, Pat.
- Cairns, Holly.
- Canney, Seán.
- Clarke, Sorca.
- Collins, Joan.
- Connolly, Catherine.
- Conway-Walsh, Rose.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrell, Mairéad.
- Gannon, Gary.
- Gould, Thomas.
- Guirke, Johnny.
- Harkin, Marian.
- Healy-Rae, Danny.
- Howlin, Brendan.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Lowry, Michael.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- McGrath, Mattie.
- McNamara, Michael.
- Mitchell, Denise.
- Munster, Imelda.
- Murphy, Catherine.
- Murphy, Verona.
- Mythen, Johnny.
- Nash, Ged.
- O'Callaghan, Cian.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Shanahan, Matt.
- Sherlock, Sean.
- Shortall, Róisín.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Tully, Pauline.
- Ward, Mark.
- Whitmore, Jennifer.
- Wynne, Violet-Anne.
Staon
Tellers: Tá, Deputies Hildegarde Naughton and Cormac Devlin; Níl, Deputies Pádraig Mac Lochlainn and Denise Mitchell.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided by electronic means.
A Cheann Comhairle, this Government amendment is completely unnecessary. This is about an approach from parents of children in pain, with scoliosis, who have been failed by this State in a shameful way. Under Standing Order 83(3)(b), I propose that the vote be taken by other than electronic means.
Question again put:
The Dáil divided: Tá, 71; Níl, 61; Staon, 0.
Tá
- Brophy, Colm.
- Browne, James.
- Bruton, Richard.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Byrne, Thomas.
- Cahill, Jackie.
- Calleary, Dara.
- Cannon, Ciarán.
- Carroll MacNeill, Jennifer.
- Chambers, Jack.
- Coveney, Simon.
- Cowen, Barry.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Donohoe, Paschal.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- English, Damien.
- Farrell, Alan.
- Feighan, Frankie.
- Flaherty, Joe.
- Fleming, Sean.
- Foley, Norma.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Heydon, Martin.
- Higgins, Emer.
- Humphreys, Heather.
- Lahart, John.
- Lawless, James.
- Leddin, Brian.
- Madigan, Josepha.
- Martin, Catherine.
- Martin, Micheál.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McGuinness, John.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Naughton, Hildegarde.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Connor, James.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Donovan, Patrick.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Rabbitte, Anne.
- Richmond, Neale.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Troy, Robert.
Níl
- Andrews, Chris.
- Bacik, Ivana.
- Barry, Mick.
- Berry, Cathal.
- Brady, John.
- Browne, Martin.
- Buckley, Pat.
- Cairns, Holly.
- Canney, Seán.
- Clarke, Sorca.
- Collins, Joan.
- Connolly, Catherine.
- Conway-Walsh, Rose.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrell, Mairéad.
- Funchion, Kathleen.
- Gannon, Gary.
- Gould, Thomas.
- Guirke, Johnny.
- Harkin, Marian.
- Healy-Rae, Danny.
- Howlin, Brendan.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- McGrath, Mattie.
- McNamara, Michael.
- Mitchell, Denise.
- Munster, Imelda.
- Murphy, Catherine.
- Murphy, Paul.
- Murphy, Verona.
- Mythen, Johnny.
- Nash, Ged.
- O'Callaghan, Cian.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Shanahan, Matt.
- Sherlock, Sean.
- Shortall, Róisín.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Tully, Pauline.
- Ward, Mark.
- Whitmore, Jennifer.
- Wynne, Violet-Anne.
Staon
Tellers: Tá, Deputies Cormac Devlin and Hildegarde Naughton; Níl, Deputies Denise Mitchell and Pádraig Mac Lochlainn.
Question declared carried.