I thank Deputy Martin for his question. I, no more than the Minister, found it difficult to watch this programme, and the stories of Betty and Pat, and Peter and Kate and Patricia, and Elaine and John and Alan, and Kira and Darragh and Megan speak for themselves. This is 2017 and nobody wants to see a situation like this.

A perception that there was an attempt to cover up figures is not true. Since the National Treatment Purchase Fund started in 2002, this was always the way, according to best international standards at that time, that these figures were presented. Patients would get a call to say they would have an operation or a treatment. Those who have had one treatment but need a second were never counted in the figures. Irrespective of that, it does nothing for the parents of children who have curvature of the spine, which Deputy Martin mentioned. This is a serious issue, and Deputy Martin raised it in that spirit.

The €2 million that was provided in 2016-2017 specifically for surgery for scoliosis has meant that 133 spinal fusion treatments for scoliosis have been conducted in 2016 for children under the age of 16 years and adolescents between the ages of 16 and 18 years, of which 44 were outsourced to the independent or private sector or the UK under the HSE winter initiative funding.

Deputy Martin himself has been through this. During the previous Minister for Health's time, the big question about scoliosis was whether we had the theatre capacity. A sum of €3 million was found and invested in a theatre specifically for this purpose in Crumlin and it is still not open. The Minister is meeting the chief executive later today, as well as the NTPF and the HSE. He wants to make it clear that the scoliosis issue is an absolute priority, that he will do more and that he will refer again to the question of the private sector to assist with this. The opening of a brand new theatre is dependent on the recruitment of adequately trained staff and exceptional efforts are being made to recruit staff who are qualified to do this work. This is an issue the Minister was upset about.

In respect to the situation that applies generally, €900 million more has gone into the health system this year than last year. It is now €14.5 billion. The strategy of health reform is correct in the decision in respect of the National Maternity Hospital, the decision in respect of the national children's hospital, the provision of primary care centres throughout the country and the reduction in the waiting list for routine colonoscopies by 90%. These are all improvements in the health service which of themselves and in respect of the staff who deliver them are also to be commended. However, this is not something that we can stand over.

I found it difficult to watch the programme but it is very necessary that these programmes and patients' stories be heard in 2017. I would point out that the function of the Minister for Health, on behalf of Government, is to set the overall policy and strategy and to provide funding within what can be provided, that is, €14.5 billion or €900 million more than last year. Those charged with delivering the services differ in their opinions. I heard opinions today about bringing in business people. I heard opinions today about doing a lot of small things together.

There were also other opinions. None of them deals with the issue of the child who is waiting for scoliosis treatment. Today the Minister, in seeking a whole-of-Government response, will examine what it takes to open a theatre which the taxpayer paid €3 million for but which is not open and was designed specifically for dealing with children with scoliosis.

The way the waiting lists are calculated was changed in many years - 2005, 2007, 2009, 2010, 2011 and 2014. The most recent change has been to extend the targets to 18 months, which is extraordinary. Why did the Government bury the National Treatment Purchase Fund in 2011? We could never get an answer as to why the former Minister, Senator James Reilly, did that. He took away a capacity that got operations carried out for citizens. Money was allocated and the individual got the hip, cataract or whatever operation was required. The Government buried that at a time when there was increasing pressure on the public sector. The Government was warned time and again about the lists getting worse but the former Ministers, Senator Reilly and Deputy Varadkar, were in denial about that and, in particular, the length of time on waiting lists. That is a key metric here. The time was down to six and three months for the vast majority of disciplines and procedures, but now the new target is 18 months and 12 months in some cases.

On the scoliosis situation, the Taoiseach says 44 surgeries were outsourced. All of them should be done, whatever it takes. The Taoiseach knows about the nursing crisis; he has known about it for three years. We pointed out in the Dáil that the recruitment of theatre nurses was the greatest crisis in nursing recruitment over the last three years, but nothing has been done to incentivise the recruitment and, critically, the retention of theatre nurses. That exacerbated the situation that already existed due to closing down the treatment purchase fund from 2011 and the stress and strain on capacity in the public system up to recent times. There is also the issue of clinical prioritisation. The growth of C contracts, for example, will put greater strain on public sector capacity to carry out surgery as well. These issues must be examined.

However, it is urgent that the money not be drip-fed to the treatment purchase fund but fast-tracked and accelerated so there are early significant amounts of money going to the purchase of operations for people such as those we saw last night. It is unacceptable, as the Minister and everybody say. Those people should not be waiting any longer in their current chronic pain. There is a way to deal with it - go out, find the capacity and have the operations carried out for those people. That is the immediate first step, after which there are wider issues to be dealt with.

That is exactly what the Minister is going to do. The fact is that when this came to light a number of years ago due to the length of the waiting list and the numbers on the list, a new theatre was provided but it still has not opened. There is money in the budget to recruit 1,000 nurses this year. There are talks today between the Department, the HSE and the Irish Nurses and Midwives Organisation, INMO, about this. I heard somebody with considerable experience in the medical profession say this morning that the NTPF was a waste of money. I agree that it has a role to play here. Clearly, the 133 spinal fusions carried out last year and the 44 in the private sector speak for themselves.

It did the job. Some people did not like it that it did the job.

The counting of the list has been the same since 2002. In fairness, when Deputy Martin introduced that list in 2002 it was best international practice. The counting of the list has not changed to any extent. There is no intention to hide anything in terms of numbers. Some of the people have already had an initial treatment and will be called back. They were never counted in the past. They are counted now. That is fair enough but it does not do anything for those who suffer with the difficulties and challenges of scoliosis. The Minister will be talking to the chief executive of Crumlin hospital, the HSE and the NTPF today and the focus will be on scoliosis, as the Deputy quite correctly requests, in order that no children will be left in their current difficulties and pain. It is not acceptable. We have all said that and everybody understands it. The problem is how to get the theatre, paid for by the taxpayer, open to provide relief and comfort to the children with this problem.

I am not impressed by the Taoiseach's reply. Last night, the "RTE Investigates" programme showed that tens of thousands of patients waiting for operations and procedures are not even included in the official waiting list numbers published by the National Treatment Purchase Fund.

I commend the programme makers. It appears that over 80,000 patients have been excluded from the official figures. In addition, 81,000 others are on waiting lists, some in great difficulties. The total is twice the capacity of Croke Park. God knows how many more are waiting to see consultants. The Minister for Health was aware of the scandal. How could he not have known? All of us here have made representations on behalf of citizens who are on waiting lists. We are not talking about a small number of patients. We are talking about the lives and well-being of more than 80,000 citizens, some of whom, including children, are, as we saw on last night's programme, languishing in tremendous pain.

This is just another example of a health service that is in a state of perpetual crisis. I disagree completely with the Taoiseach. It is not just about misleading the public about waiting lists, it is about the 587 people who are on trolleys today, cancelled surgeries, thousands of hospital beds removed and a two-tier system in which health workers, particularly nurses, are not properly treated, and where patients suffer. The plight of patients, especially children with scoliosis, and the bravery and anguish of their families, captured so graphically on last night's programme, has further eroded confidence in the Government, our general politics, our political system and our health service.

There is a complete lack of accountability. The Minister is not accountable. The Taoiseach, while he has Fianna Fáil's support, is not accountable. We should dispense with the pretence that anyone present will get any real answers from the Taoiseach today - not me, not the patients, not their families, not the people working in the health service. Instead, I propose a single, integrated hospital waiting list management system. We published this as part of our Better for Health policy. In December 2015, we presented it to the Taoiseach and the Minister at the time. It is a plan for a public health service. While we do not pretend it is an easy fix, we show it can be done. On the issue of management of waiting lists, we have proposed a new system called "Comhliosta". This would replace the current system and be responsible for generating maximum waiting times based on a single, integrated hospital waiting list system.

The Sinn Féin health spokesperson, Deputy O'Reilly, wrote to the Minister for Health, Deputy Harris, on 17 August last requesting a meeting to discuss the proposal. She is still waiting for him to reply. The Minister may well grin.

I am not grinning.

Yes, the Minister is grinning.

I have spoken to Deputy O'Reilly.

All I ask is that the Minister consider the proposal, take it away, read it and come back with a reply.

One of the first things the Minister did on his appointment was to ask the House and everybody involved to debate a ten-year programme for the health system that would remove the political imperative from much of it. Last week, I spoke to Deputy Shortall and she asked me for another meeting, which we will hold in the next week or ten days.

The list system is nothing new. It has been in place since 2002 and the counting of the list has always been the same. It is nothing new under this or any previous Minister in the 15 years since it was established. A total of 70% of patients are seen within eight months. The Deputy's proposal for a single list may have merit. His spokesperson is on the committee dealing with a ten-year programme for the health system. It deserves some consideration. However, what we need is a system that does not change from month to month or year to year.

We have had a counting system since 2002 without changing it. The other elements, the pre-admittance and people who have had a procedure and who need to be called back for a second one, have never been counted as part of those lists, although they have been published on a monthly basis.

The new orthopaedic unit was completed in 2015. While it is in use, it has not added to capacity in Crumlin because of rolling closures. In that sense, two international nurses commenced in Crumlin in January. Two more are due to commence in March and a further 16 have been offered posts which allows the registration process to commence which can take four months. The adaptation programme used to be six weeks but has been reduced to two days, which is progress.

Every opportunity in recruitment and retention is followed through diligently, including working with the HSE and the international recruitment drive to support additional capacity at the hospital. As of 31 January, there were 193 patients awaiting spinal procedures in Crumlin, of which 143 were for new spinal fusions. On average there are additional 250 patients every year, 200 additional patients to Crumlin and 50 to Temple Street. The children’s hospital group has confirmed there were 133 spinal fusions for scoliosis conducted in 2016, of which 44 were carried out by the private sector.

The idea for a committee to look at a ten-year health plan did not come from the Minister but from an Teachta Róisín Shortall. Both Deputies O’Reilly and Buckley, on behalf of Sinn Féin, play a full part in that committee. The waiting list figures were kept away from that committee, however.

I asked the Taoiseach to consider the proposition for a single integrated hospital waiting list system. I even sent him a copy of our initiative again today. It is not an accident that our health service is in perpetual crisis. The fact is neither the Taoiseach’s Government nor its predecessor in Fianna Fáil are committed to a public health service. The Taoiseach is ideologically against that proposition. He does not believe citizens have an entitlement to a wraparound health service from the cradle to the grave as well as one which is of the highest possible standards.

Instead, the Taoiseach’s ideological position favours the two-tier system and the privatisation of those sectors which can make profit. Last month, the chief executive of the National Treatment Purchase Fund, NTPF, said the private sector is the most efficient and clinically effective way of having patients seen quickly. No one who saw last night’s television programme could call it efficient or clinically effective. From 9 January 2017, the NTPF claimed key targets for the HSE’s 2016 waiting list action plan had been achieved. That is the boast. That is the reason for the manipulated figures.

Will the Taoiseach take our proposition - some of us will raise it next week - and come back with a considered response to it?

That can be done in the context of the ten-year proposal being examined by the all-party Oireachtas committee. Deputy Adams is to be commended on putting forward a proposition like that.

However, it is important that the system used in which the lists are counted should not change. They have been counted in the same way since 2002 when the NTPF system was first introduced.

The Deputy is completely and utterly way off the mark when he says the Government’s intention is to introduce a private health system. The Government’s absolute priority is a public health system which delivers for patients when they need treatment and as close to them as possible. Despite what the Deputy thinks, that is a fact of life.

The Taoiseach also wants to keep the recovery going.

The Deputy could use the service himself some time.

Two new consultant paediatric orthopaedic posts were approved for 2016 for Crumlin. This has increased the work rate to a current total of more than three whole-time equivalent posts, an increase since the end of 2015. One person has taken up a post providing some less complex spinal surgery along with other orthopaedic work. The second post was filled by a surgeon who was already working full-time in Crumlin and will now be working full-time on paediatric surgery. This creates a vacancy for the children’s hospital group in Crumlin and Tallaght. They are now discussing how that post should best be structured.

When that vacancy is filled, it is envisaged that at the end of this year there will be six people in posts of particular specialty in this case. The increase in consultant manpower is intended to enhance the overall service for children. It will be further discussed by the Minister with the chief executive today.