I must now ask the Minister or the Minister of State to make concluding remarks.

I thank colleagues for this debate, which has been very useful.

There is a lot of detail here. At the core of this are boys and girls and young men and young women, some of whom have had surgery and are very distressed about what has happened and, unfortunately, many of whom are still waiting too long for surgery. Every single thing that we have done, will do and are doing in response to this is to serve the patients, in the first instance, and their families. That is the only thing we are motivated by. As I said previously, a vast investment has been made by the Irish people through the Government into these services, including €19 million, 150 extra healthcare professionals who have already been hired, a fifth theatre will open next week and a second MRI machine will come online in the coming weeks. Numerous hospital, medical and surgical beds have already been brought online and fully staffed, and more are coming. With this additional activity coming next week and in subsequent weeks, we must see a step change in the number of procedures being performed for these children. Critically, that must translate into us beginning to move as fast as we can to every child being seen within four months, unless it is clinically indicated.

Various issues have been raised. I am going to use the time to go back over some to give absolute clarity. On the inclusion of families and advocacy groups in the terms of reference, the answer is absolutely. They will meet the Taoiseach and myself this week and the reviewer when he begins. The review is independent. The lead reviewer is an independent international expert. He has full discretion to do whatever he wants. He can go as wide and deep as he wants. He will have my full support. He will not report to CHI; he will report to the chief clinical officer of the HSE. I will meet the reviewer and if there is any hint or whisper that anybody is trying to steer this reviewer in any particular direction, within our health services, he can bring that directly to me. I state very clearly that there is a zero-tolerance approach to this. This reviewer has full discretion to go where he wants and review what he wants. He will be adequately resourced to do that.

The Crumlin review will be published on Thursday and the families will be met tomorrow. The review is of a small number of children; I have been advised that nothing unexpected was found in terms of additional complications.

Does it involve children with spina bifida?

Yes. There are wider issues regarding governance. This review is not just looking at the 20 children involved in this situation. The review is looking at that and at the use of non-medical equipment but he will go much wider, not just on Temple Street but across Children's Health Ireland and right across paediatric orthopaedics so that I, and all of us, on behalf of these children and their families, can be satisfied that every single thing that can be done is being done for them.

The investment includes both surgery and post-operative care. We do not have the level of surgery and post-operative care we need to fully deal with waiting times. More resources are coming online, much of it in the next number of weeks. Some Deputies asked what the additional resources are. I think I covered that; it is about 160 extra staff, 150 of whom are in place, the second MRI scanner in Crumlin and the additional operating theatre in Temple Street.

One thing I had not mentioned was that some of the less complex procedures, such as intrathecal chemotherapy, are being moved out of theatre to procedural rooms, freeing up more theatre space for more complex work. Many beds have been added, along with additional staff, including registrars, consultants, radiographers, nurses, physiotherapists, occupational therapists and associated posts. We went through the timing. If colleagues have any further questions based on today, we will get whatever is required. I also wish to offer a briefing from the Department, if members of the Joint Committee on Health would like it. I am happy to organise that.

Temple Street is now implementing the recommendations from the Boston review. I expect there will be a more actionable response from the independent review. The chief clinical officer and I expect the first interim report before the end of the year, which I will publish and share with patients, families, Members of the Oireachtas and more broadly.

That concludes statements and questions and answers on Children's Health Ireland - patient safety concerns and reviews in paediatric orthopaedic surgical services. I thank Members for their co-operation in getting this business done.