In recent years, nothing has been more heart-rending than the shocking waiting times for children and young people for surgery for scoliosis. Children's health has been compromised by the undue delays and in many cases, optimal outcomes have not been achieved as a result of the delays. Getting the surgery on time is critical not only to full recovery but to the proper, full development of a child's potential. On 1 September on the "Late Late Show" there were very revealing stories told, particularly by Megan Halvey Ryan who waited 18 months for an operation. As a result of the long delay, she had to have full spinal surgery and has less flexibility because of the nature of the operation she had to have as a result of the long delay. The Taoiseach's predecessor, Deputy Enda Kenny, said it would be an absolute priority that those on the waiting list would not have to wait longer than four months and that would be the case by the end of 2017. However, that was in March and the situation as of last month is that those waiting list targets have been missed. The number of children waiting for more than four months has increased from 124 to 145 and for some of those it is much longer than four months. I am dealing with a case of a young boy aged 15 years who has been diagnosed as needing urgent surgery. In August 2016, he was put on the surgical waiting list. The surgeon is saying it is urgent. He has complications caused by other conditions such as spina bifida. He is in a wheelchair. I have spoken to his mother, who emailed me this morning saying that humanity, empathy and compassion need to be taken into account when dealing with her son's case. She is at her wit's end. She is totally stressed as a result of the lack of progress on the waiting time. There is also the fear that if it does not happen on time, his health will be further compromised. In his case and others, what has been going on for the past three to four years has been quite shocking and represents a failure in providing resources. Will the Taoiseach indicate that the waiting list target - the absolute priority set by his predecessor - will be met by the end of this year and that urgency will continue to be attached to cases such as that of the young man I referenced and about whom I have communicated with the Minister and others?

It is quite shocking to have to go back to the mother of such a child. The mother is relatively helpless in progressing the case further. Can the Taoiseach give a firm commitment that waiting targets will be achieved?

I thank the Deputy for raising this very important issue, which is very close to my heart. I took an interest in it, both as a doctor and as Minister for Health. We can all accept that far too many people in Ireland are waiting far too long for treatment. People are well aware that about 600,000 people are on one form of waiting list or another. More than half of those people will be seen in less than six months and about a third of people are seen in less than three months. However, many people are still waiting more than three months and more than six months, which is not something we want to continue or to stand over.

The waiting lists for surgery for inpatient and day-case treatment are starting to fall. The most recent figures from August show a fall of 2,000 in the number of people waiting for surgery - waiting for procedures or operations. That is due in part to additional investment in the health service with a record budget this year and additional funds provided to the National Treatment Purchase Fund.

Dealing with scoliosis in particular, as the Deputy knows, the Government has a scoliosis action plan in place. When I was Minister for Health I met the surgeons who perform these operations and met representatives of some of the interest groups. One of their big requests was that a new theatre be provided in Crumlin hospital. That cost about €2 million or €3 million. That new theatre is now in place and open. Quite a number of cases are now being outsourced to other hospitals including, for example, to Blackrock and Stanmore in London. The number of operations has increased. It is a good sign that more people are being treated and having their surgery, but people are still waiting a very long time.

The four-month target was set by the director general of the Health Service Executive, which is funded to meet that target. I will certainly be calling on the HSE to deliver on that target. I discussed it with the Minister for Health in the past couple of days and it is intended to have a treatment plan and a treatment offer for every child who is waiting for scoliosis surgery. It may not be possible to perform all operations in Crumlin by the surgeon of choice, but certainly people will be given the offer of treatment abroad if they are waiting more than four to six months on the surgical waiting list for that. Of course we understand that some parents will - for totally legitimate reasons - prefer to have the treatment in their own country rather than going abroad, but the treatment abroad option will be there.

If the Taoiseach is honest, he will admit the only reason progress was made was because the Government was shamed into it by television programmes and ones on RTE in particular, which highlighted earlier this year the long waiting times for young people with scoliosis in particular. It took that kind of media profile to get action from the Government because in 2014, 2015 and 2016 the resources were not provided and the scoliosis waiting lists were allowed to grow far too long. Parents will say that whoever gets on the media gets a better chance of getting an operation which is obviously not the route to take. The Government had to be dragged kicking and screaming to adopt the National Treatment Purchase Fund as a strategy to reduce waiting times. It is belated and has been too slow in implementation.

On the scoliosis question, it is the Minister for Health who is responsible to ensure this happens. The Taoiseach cannot keep passing the buck and trying to detach himself and the Government from the reality on the ground as it affects young children's health and, crucially, their outcomes. We want an optimal outcome for these children. Because of the complications that apply in certain cases, not every child will be in a position to go overseas for an operation. It is vital that every action is taken. We need ministerial and Government oversight to ensure what the Ombudsman for Children has declared to be a contravention of children's rights is rectified and that children in this case get their operations on time to ensure they get an optimal outcome as a result of the treatment of their condition.

It is not an issue of shame. All of us in Ireland and in this society should be ashamed that children have to wait such a prolonged period for operations.

Sadly, this is a problem that has existed for as long as I can remember. When I was a medical student, there were long waits for scoliosis surgery. I believe Deputy Micheál Martin was the Minister for Health and Children at that particular time. The waiting lists might not have been as long as they are now but they certainly were very long.

The Taoiseach is blaming everybody but himself.

This is an issue that has been a problem for us certainly as long as I can remember. The question I want to answer and the one I think is the most important to be answered is what are we doing about it. The new theatre in Crumlin is now open. The additional nurses are now in post in Crumlin and Temple Street and an additional orthopaedic surgeon will commence work in Crumlin in early October. A total of 226 surgeries have taken place in Crumlin and Temple Street so far this year, which is a significant increase already on last year. A total of 23 cases have been outsourced to the Mater, Cappagh and Stanmore and the HSE has also completed an international tender for paediatric spinal fusion procedures to take place in three other hospitals. Those hospitals will commence patient reviews immediately with a view to commencing treatment in October 2017.

It is fair to say that we are pulling out all the stops and doing everything we can to make sure more children have the surgery they need within an acceptable time period, and if that involves offering people treatment abroad, we will fund that but we understand and accept that for perfectly legitimate reasons every parent may not wish to accept the offer of treatment abroad.