Seven years ago, the then Minister for Health and the Taoiseach's Fine Gael colleague, Deputy Simon Harris, promised that no child would be waiting longer than four months for scoliosis surgery. That promise was never met and of all the Government's broken promises, I think it is one of the most callous. The fact is there are more children on scoliosis-related waiting lists now than when the Minister gave that commitment in 2017. This has happened on the Taoiseach's watch. There remain, as of this month, 327 children on waiting lists for scoliosis-related surgery. It is not acceptable.

The families and children involved deserve better. Last night, I met with them and I listened to their concerns. I listened to the tragic stories of those families and heard about the pain that their children are in and the life-limiting state in which many of these children find themselves. What these children and families must endure is heart-breaking. They feel they have been let down because Government promises have been made and broken time and again.

Mothaíonn na teaghlaigh seo gur ligeadh síos iad toisc go bhfuil gealltanais an Rialtais briste arís agus arís eile.

Two years ago, in 2022, I raised the issue of children with scoliosis waiting years here in the Dáil. I visited Cappagh Hospital and I met with CHI management. I also met with parents and advocacy groups. The Government subsequently committed to €19 million of additional spending on the promise that this would result in no child waiting longer than four months by the end of 2022. That promise has also been broken.

Astoundingly, the Minister for Health, Deputy Stephen Donnelly, informed the Dáil last night that he cannot guarantee that the €19 million was spent for the purposes for which it was intended. He does not know. The Government does not know. What we do know is that far too many children are waiting and waiting.

One such child is Kylie Ann from Donegal. Kylie Ann is ten years old and she has been waiting five years for life-changing surgery. That is half of her young life. Kylie Ann’s mother has challenged all of us here to see Kylie Ann as she sees her, with love, to give her the chance and the quality of life she deserves. I think we should meet that challenge. That is why our motion tonight matters so much. These children deserve better.

Will the Taoiseach agree to work with us and the parents and advocates to establish a task force that works? Will he work with us to achieve accountability and transparency? Will he work with us to put in place a plan that delivers finally for these children? There is an urgency to all this. Every and all treatment options must be on the table for these children and young people. Everyone must commit to doing everything necessary to end the scandal of children waiting for spinal surgery once and for all.

Our motion sets out that plan to address all of these matters in co-operation with parents, advocates, clinicians and the Taoiseach. As a gesture of seriousness and goodwill, I ask the Taoiseach to withdraw the Government's amendment to our motion this evening. I ask that he work collectively with us to finally crack this and get the job done. The plan we have set out is the plan the families want implemented. As I understand, they are looking to meet the Taoiseach to discuss that plan. Will he meet them?

Gabhaim buíochas leis an Teachta as a cuid ceisteanna. Tá a fhios agam go bhfuil fadhb mhór againn leis na seirbhísí sin agus tá brón orm faoi. I know from my own experience, having worked in medicine as a doctor in what seems a long time ago now, that the problem of failures and inadequate services when it comes to spinal surgery, scoliosis and spina bifida surgery for children, goes back generations, sadly. It goes back many more lifetimes than these children have yet experienced. I guarantee that if it had ever been an issue simply of money, political will or how much we care about this, it would have been resolved a long time ago. I do not have adequate answers as to why it has not been fixed but I intend to do anything I can to establish why not and to put things right. The Deputy has my assurance on that point and I would be happy to work with her, provided it is in good faith, to deal with this issue because it should not be a political football. I know that is not the Deputy’s intention but there are others who would make it such. We need to stand together against those and work together to resolve this issue, which will take more than one Government to solve, in my view, but at least, let us get started on it.

At the outset, I want to acknowledge that there is no doubting the worry, anxiety and pain for many patients and families attending these services. A comprehensive patient safety review has been commissioned into paediatric orthopaedic surgery services. This is independent and is led by independent expert Mr. Selvadurai Nayagam. Concerns initially related to the clinical outcomes of some complex surgery, including what appears to be a higher than normal incidence of post-operative complications and infections and two serious surgical incidents. This, of course, does not necessarily mean that somebody did something wrong. These may have been high-risk patients that other doctors would not operate on but we need to make sure we know the facts before we make any further decisions.

Two additional patient groups are now being included. Patients have been randomly selected for the purpose of audit and patients have been identified as potential cases of concern by other surgeons in CHI. Those directly affected have been informed and patient advocates have also been informed. After meeting with the paediatric orthopaedic surgeons, the Minister for Health has also determined that a dedicated paediatric spinal surgery unit should be established. Mr. David Moore, a consultant surgeon, has recently been appointed to head it up. The Minister met him in January. Senior staff have been appointed to the new unit and the Minister has requested that a task force be convened as soon as possible with an independent chair. The task force will include all stakeholders, including patient representatives and clinicians. This is a model that has worked well in other areas, such as haemophilia and cystic fibrosis.

The Minister wrote to all advocacy groups and invited them to meet with him, seeking their engagement and views on the terms of reference for this task force, which will have an independent chairperson.

He met with a number of the groups earlier this week. The Minister's invitation to meet those who did not attend or request separate meetings remains open. Mr. Nayagam has met with the Minister for Health, families, patient representatives and other stakeholders following which he finalised the terms of reference for his independent review. In addition, the Minister has asked HIQA, the independent patient safety regulator, to carry out a statutory review of springs that were not CE marked.

On waiting lists, we have increased the numbers of procedures being carried out significantly. In 2019, which we often use as a base year for comparison because it was the year before the pandemic, 380 spinal procedures were carried out. That went up to 509 in 2022. In 2023, 464 procedures were carried out. There has been a big increase in the number of procedures being carried out and waiting lists have gone down. As of the end of last year, 78 patients were on the active waiting list, which was a reduction. Some 231 patients are awaiting spinal procedures.

I am advised by the Department of Health that Sinn Féin has miscalculated the waiting list figures. The claim that 327 children are on the waiting list is incorrect, even if those who are only waiting a few weeks are included.

Tá níos mó ná fadhb ann sa scéal seo. Tá sé scannalach go bhfuil daoine óga ag feitheamh is ag feitheamh is ag feitheamh agus ag fulaingt mar seo. Tá sé scannalach agus is é sin an focal ceart atá i gceist. I have being raising this issue here for almost a decade, as have other colleagues. It is time for the Taoiseach to confess and own up to the fact that it is utterly scandalous that children in that degree of pain are left to wait. More scandalous yet is the fact that the Minister for Health could state last night that he does not know where the €19 million that was to be dedicated for the children's treatment is. He cannot tell us where that money went. I am not interested in a political football; nor are the families and their advocates. We are interested in a credible, good-faith response from the Government. That means accountability and it means action. It is certainly not acceptable that the Taoiseach cannot answer basic questions on where resources have gone.

Will the Government withdraw the amendment to the Private Members' motion? Will it accept in good faith the plan that the families and advocates support? Will the Taoiseach meet with them to discuss that very plan?

I thank the Deputy. Is fadhb mhór í agus is tubaiste é i mo thuairim agus táimid ag lorg níos mó eolais agus ag iarraidh an fhadhb sin a réiteach. I have met the patient groups and I would be happy to meet them again. It is not my practice to organise meetings on the floor of the House, but I will be happy to meet them again as soon as there is a gap in my diary. There are different groups involved, however, and they do not all agree with each other. The Deputy knows how complicated it can be to deal with an issue when there are different groups with different perspectives representing the same people in the context of what should and should not be done.

Acting in good faith means being big enough to admit when one has got one's numbers wrong. It also means not misrepresenting the Minister in the House. It is not the case that we do not know where the €19 million was spent. We know where it was spent. It provided for an additional 204 healthcare professionals working, at least some of the time, on spinal surgery at CHI at Temple Street, CHI at Crumlin and the National Orthopaedic Hospital Cappagh. It also provided for a fifth theatre in Temple Street, which is now open. It further provided for an additional MRI scanner and for additional beds. What we cannot establish for certain is exactly how much of the €19 million was spent on this. We need to find that out.

That is the point.

No, it is not the point. The Deputy had used misinformation about the waiting lists here in the House.

Are you serious? Let it publish details relating to the waiting lists.

She has also claimed that the Minister said that he did not know where the money was spent. That is not what he said. It was spent on 200 staff, more beds, a new theatre-----

He should spend it for the purpose for which it was intended.

-----and a new MRI scanner. If the Deputy and her party honestly want to be involved in helping us to come up with a solution, which should not be political football, they need a different approach.

Withdraw the amendment.

Can we stop the heckling Members, please. I call Deputy Bacik.

Gabhaim buíochas leis an gCeann Comhairle. Upon taking office in December 2022, the Taoiseach's stated aim was to make Ireland the best country in which to be a child and to improve well-being and opportunity for children. However, there are many children in Ireland today who are being failed by the State. I am talking about children who are denied care in our health system, who are waiting for surgery, who are lost in mental health services or who are not receiving the care and support they so badly need. No parent wants to make public the private pain of their son or daughter, but we are seeing so many who are utterly desperate. Some parents have even been driven to posting videos on social media of their young children sobbing with pain through the night in a desperate effort to secure appropriate healthcare. Those videos are harrowing. It is even more harrowing to meet the parents and the children and hear their stories.

As we know, in 2017, the then Minister for Health, Deputy Harris, made a commitment that no child would be made to wait more than four months for surgery. Yet, children are still waiting longer for spina bifida or scoliosis surgery than was the case when the Government took office. As my colleague, Deputy Duncan Smith, said in the debate last night, 78% of children are waiting longer than Sláintecare target times for paediatric and orthopaedic inpatient appointments and 81% are waiting longer than that target for inpatient urology services. There are also the outpatient waiting lists.

Let us look at the children's mental health services. Yesterday, we heard yesterday from the Children’s Rights Alliance that, for the third year in a row, the Government deserves only an E grade, an unacceptable grade, in respect of access to children's mental health services. Four years ago, the Government made a commitment to end the admission of children to adult psychiatric wards. Yet despite successive damning reports from the Mental Health Commission, children’s ombudsman, and others, the Government has apparently rowed back on that important commitment. The Department of Health has acknowledged that in some cases children with mental health problems will continue to be admitted to inappropriate wards. Last year, 50% of children were unjustifiably admitted to such wards because there were no beds available in child and adolescent mental health services, CAMHS, units. We know that almost a third of inpatient CAMHS beds were not operational in 2023 due to staff shortages. The waiting list for a first appointment for CAMHS stood at almost 4,000 in July 2023. This is a national disgrace.

On so many fronts, we are seeing vulnerable children let down by State health services. It appears that the Government has quietly abandoned commitments it made on children's health. It is not good enough to say that it may take two successive Government terms to recover this. I heard the Taoiseach saying that in a response earlier. There are things the Government can do now. The Irish Hospital Consultants Association has pointed to staff shortages as a real factor in driving unacceptable delays for services relating to children. Will the Government end the recruitment freeze and the embargo relating to certain grades in the health service? Will it move to tackle the outrageous waiting lists and address the failings in CAMHS that have been made so glaringly obvious in so many reports, including that from Children's Rights Alliance yesterday?

I thank the Deputy. Ireland is a very good country in which to raise a child. Out of 200 countries in the world, we are in the top ten or 20 in almost everything. We have very good maternal and neonatal health services. We have among the lowest infant mortality rates in the world. We have a very good education system with among the best education outcomes in the world. We have introduced early years education and by September the cost of childcare will be half what it was when this Government came to office. We have the free schoolbooks scheme and hot school meals schemes. We get an A grade from the Children's Rights Alliance, to which the Deputy referred, when it comes to online safety and media regulation, particularly in light of the appointment of the Online Safety Commissioner. Of the 16 matters on which the Children's Rights Alliance grades us, we are up in four, the same in 12 and down in none. We fail only in only one of the 16. I absolutely believe that this is not good enough, because my ambition is something more. It is for this to be the best country in the world to be a child, bar none. That is one of the things which drives my work and that of the Government.

On the recruitment freeze, I know the Deputy wants to know the facts - that is not always the case with people in this House but she is one of the ones who does - since the Government came to office, 26,000 more people are working in our public health service than was the case before. That includes 1,000 more consultants, 2,000 more doctors and 6,000 more nurses and midwives. By extra I mean extra, not replacements. When the recruitment freeze was in place last year, the total number of staff in the HSE increased by more in a year than has been the case for many years. Some 8,000 extra staff were hired by the HSE last year. This year, during the so-called recruitment freeze, the HSE has the authority to hire an extra 3,000 staff. Those are the facts.

What we cannot allow the HSE to do, which is what happened in the past, is that money allocated for one purpose is spent on another. It may be a worthy purpose, but that is not the point. I refer, for example, to funding being allocated to hire 50 staff in a certain area and then 50 staff being hired somewhere else for some other purpose else. While all of the latter might be doing really important work, that type of thing is just not good enough.

The new CEO of the HSE agrees with me and is making those changes.

On children being admitted to adult psychiatric units, we stand over our promise, I restate it and we are making progress in that regard. In 2019, the year before this Government came to office, 54 children were placed in adult wards. Last year that was down to 12, so we are going in the right direction in that regard. All decisions to put a child in an adult ward are made by a consultant psychiatrist with the interest of protecting the young person and their well-being. The majority were over 17 years, all were voluntarily detained for a short period of time and in some cases the young people even turned 18 and transferred to adult care during their admission. No consultant takes the decision lightly and it is often done in consultation with parents. I have been there, Deputy, and sometimes it makes sense for a 17-year-old or even a 16-year-old to be in a private room on an adult ward rather than in a children's unit 200 miles away.

We are certainly ready to acknowledge progress where it has been made and we have welcomed moves by Government to review how additional funding for spinal surgery was spent by the VHI as that is important. However, I repeat that it is just not good enough for the Taoiseach to say it will take two Governments to resolve issues with children's health in Ireland. He is in government and has been for many years now and it is not good enough that we are still seeing these waiting lists.

Let us look at facts. The Irish Hospital Consultants Association tells us the difficulty with filling permanent consultant posts is a root cause of what it in its words are "unacceptably long" child waiting lists. In August last year the association told us over 100,000 children and young people were on hospital waiting lists with 20,600 children waiting longer than a year for treatment or assessment by a hospital consultant. The latest HSE data reveals the number of unfilled permanent consultant posts has risen to a record 933 and the Irish Hospital Consultants Association says this is the highest consultant vacancy rate ever. These are the facts, just as there are facts on the admission of children to adult psychiatric units. A commitment was made by the Taoiseach's Government four years ago to end this practice yet we see 50% of those children admitted to an adult unit last year. This was done because no bed was available in a CAMHS unit. There are unacceptable waiting lists for CAMHS services. There are the facts and the Taoiseach's Government has simply not done enough to address them.

Hear, hear.

I thank the Deputy. I will clarify one point and I appreciate I was not clear. When I say it will take more than one Government to solve some of these problems, I do not mean two Governments over ten years; I mean this Government has a year to run and this problem is not going to be solved within a year. The opening of the new children's hospital next year and everything around that creates a once-in-a-generation opportunity to dramatically improve paediatric healthcare in Ireland and I am determined that should be the case.

When it comes to consultant appointments we have 1,000 more consultants now than when this Government came to office and that is significant. There was a time when the number of doctors per head of population in Ireland was below the OECD average and it is now above it. That happened during my party's term in office. The term "vacancy" as used by the IHCA is a misleading one as when the people at home hear "vacancy" they think empty, thinking that is what "vacant" means. Of course, a lot of these posts are not empty; they are filled by locums, people on contracts or through agencies.

Permanent. I said "permanent".

That is for a lot of different reasons and much of the time, unfortunately, it is in peripheral locations where consultants, especially Irish ones, are not willing to work and therefore we rely-----

"Peripheral to Dublin" is what the Taoiseach means.

-----on people to come from other parts of the world who are willing to work in places that sometimes Irish doctors are not.

I wish to clarify again the recruitment restrictions that exist do not apply to filling consultant posts on a permanent basis.

But we need the team of medics to support the consultants.