Scoliosis is a condition that affects several hundred children and adolescents in Ireland. It is a progressive disease that involves the curvature of the spine. It causes increasing difficulty with breathing and has an impact on the heart and other internal organs. As the Tánaiste can imagine, it has a particular effect on children who are sensitive with respect to their appearance as they travel through their school lives. It is a very sensitive situation. Scoliosis has an impact on the condition and mental health of children and affects how they get about the place.

This issue was forcefully brought to my attention by a young woman called Sophie from Galway. She is 15 years old. She once led a cheerful, confident and outgoing life. She had an excellent attendance record in school. She was once a grade A student. In February 2014, she was diagnosed with scoliosis. By the summer of that year, her condition had deteriorated and urgent surgery was recommended. She went through many tests and scans in preparation for the necessary surgery. Neither Sophie nor Sophie's mother has heard a word from the HSE since those tests and scans were done. She has been left in limbo since that time. That has too often been the experience of many families who carry the burden of scoliosis. It seems the HSE and the Minister do not act until people in the media, such as Ferghal Blaney of the Irish Daily Mail, contact the HSE to ask about scoliosis cases.

The delay of almost two years is now having an impact on Sophie's internal organs. When she presented herself to a GP yesterday, she learned that the curvature of her spine is now at an angle of 80°. The impact of this could puncture her lung. Worse still has been the impact on her mental health. She is no longer able to attend school. Sophie is now on anti-depressants as a consequence of having to wait two years for an intervention.

Shame.

To add insult to injury, Sophie, who is a child, received a personal letter from the HSE last week telling her that she would be sent to Barringtons Hospital in Limerick. The members of her family members celebrated and were relieved. When they rang the HSE this week, they were advised that the letter had been sent in error. Hundreds of adolescents like Sophie are languishing on waiting lists as they wait for treatment. Is the Tánaiste happy with how such children are being treated by the Government and the HSE?

Anybody who has experienced scoliosis, who has family members or friends who suffer from it or who knows someone who suffers from it will be aware that it is a very difficult condition. The impact of it is obvious when one considers that it affects growing children. I am not familiar with the details of the particular case highlighted by Deputy Keaveney. I will ask the Minister for Health to ask for a report from the HSE on the subject. I apologise for any error that has been made by the HSE. I hope the HSE will have apologised for any such error as well. I hope any error has not had too severe an impact on Sophie and her family.

In a general sense, people who are familiar with scoliosis may know that it has been the subject of a significant expansion of resources in our health system. It is important that we acknowledge that the provision being made for the number of cases to be treated has pretty much doubled in the lifetime of the Government. Treatment is now available in many different locations, some of which have seen increased capacity, including Blackrock Clinic, Cappagh hospital, which is a dedicated orthopaedic hospital, and Temple Street children's hospital. As we speak, the construction of a new theatre at Our Lady's Children's Hospital in Crumlin is under way. This will provide additional resources for dealing with this difficult condition. Two additional orthopaedic consultants have been appointed at University Hospital Galway.

This particular disease, which has a stronger presence in Ireland than in many other countries, has received significant attention. There has been a doubling of resources and an increase in the number of locations where patients are treated. In addition to dealing with cases in Blackrock, Temple Street and Crumlin, we are also now referring a number of cases to the UK Royal National Orthopaedic Hospital in Stanmore near London. This is a mechanism for dealing as quickly as possible with the cases on the list, particularly those presenting great complexity and those involving patients who may have one or more conditions in addition to scoliosis. As medical technology develops, the capacity to deal with more complex cases is improving. I assure the Deputy that the HSE, the Minister for Health and the Department of Health are allocating significant additional resources. Treatment is being provided at a number of locations in the country and, for the first time, in Stanmore near London. I hope the families and individuals who are suffering from this condition will understand that we intend to provide a greatly expanded and enhanced level of treatment. We are doing that by doubling the resources and providing orthopaedic treatment in some of the premier institutions in Ireland.

I acknowledge the Tánaiste's response. The waiting list for children with scoliosis is increasing. The time that children are having to spend on the waiting list is increasing. Teenagers with scoliosis are having to wait up to three years for early interventions. Dr. David Moore, who is a consultant in orthopaedic paediatrics, has said:

Operating on a child who has been subject to unnecessary delays between diagnosis and surgery is like [dealing with a very profound situation]. Research shows that when a child’s surgery is delayed until they hit a 70° curvature ... they are subject to a longer surgery, greater intraoperative blood loss, more fused vertebrae [and] double the blood transfusion risk.

The issue here is early intervention.

The waiting lists in Crumlin's orthopaedic department have increased significantly since March. I ask that the Tánaiste roll up her sleeves to give some level of hope to families who have been languishing on waiting lists and to children who are suffering in pain. I ask her to ensure the Minister rolls up his sleeves too. He is one of the highest paid Ministers for Health in Europe. We are asking for action for children who are languishing in pain on waiting lists.

Early intervention is the key because, after the age of 16, there is little or no point in intervening because the likelihood is that an operation to address curvature will fail. After diagnosis, what is required is investment but we do not see any urgency or political will on the part of Government in this area. Look at the waiting lists in Crumlin - they have increased since March. I acknowledge that, at a very late stage, the Government is attempting to do something but that is only because it is exposed.

Dr. Moore is known to families right around Ireland and to many Members of this House as one of our outstanding surgeons. I assure the Deputy that anything said by David Moore will be taken very seriously by me personally-----

What about the Minister for Health?

-----because I am very aware of his personal reputation and his commitment to children. His family has a very strong history of involvement in medical matters in this country. I said an additional theatre was being built in Crumlin. The Minister for Health has met Professor Moore on several occasions and additional theatre space was one of the proposals from him. The theatre is under construction at the moment and I anticipate it will be finished and available shortly. In order to reduce the waiting list, a specific examination has been done to look at the different issues which face different children. Some are straightforward but others are more complex. In order to help with that, the Stanmore clinic in London, a renowned location, has been commissioned to do some work in conjunction with the hospitals here, namely, Temple Street clinic, the royal hospital and the orthopaedic hospital. Stanmore has accepted 11 patients from Temple Street, five of whom have been waiting for a long time. Two of the families have decided not to progress with surgery-----

For a good reason.

-----on the basis of second opinions while two will be followed up with outpatient appointments in Crumlin. In fairness to the HSE and the hospitals, the staff nurses and medical consultants have a tremendous record of service to children. Anyone who is familiar with scoliosis will know how difficult it is to deal with and one has to get it right. Orthopaedic operations have to have a high level of success although that does not refer to the situation with Sophie which the Deputy said arose from a cancellation. I assure the Deputy that, in resourcing the HSE and individual hospitals and departments dealing with these issues, a concerted effort is under way to deal with children and teenagers who have been waiting a long time. As the Deputy said, this affects their whole lives.