I, too, offer my deepest sympathies and the sympathies of Aontú to the family of Kevin Flatley. This is a disaster for Kevin's family and friends. It is also a disaster that 90 gardaí have lost their lives in the line of duty since the foundation of the State. Many families fear when their parent or loved one goes out to work that they might not see them come back. Yet, those people still commit to going out and working for our safety on a daily basis.

Families are struggling to get healthcare for their children on a daily basis. The dysfunction in the healthcare system is leading to enormous delays and difficulties for families. We have a situation where families actually managed to get operations for their children. As we found out, in many cases those operations were unwarranted and unnecessary. It is currently a major problem within the State that children who may not have reached the threshold in terms of hip surgery or who may not have suffered from hip dysplasia in the first place may potentially have had operations carried out on them.

I understand that 561 people were included in the audit carried out over the past two years. If the audit is to look back 15 years, however, we could be talking about thousands of parents and children being involved.

I had to leave my son in an operating theatre for a procedure. It was not as serious as the ones we are talking about at the moment, but I saw the fear in his eyes before I left the theatre. It was very difficult to leave that location. Imagine the fury that must exist among the thousands of parents who left their children in difficult circumstances in a situation where potentially the operations they were undergoing were not necessary and could have damaged them. All operations involve challenges. Infection and surgical trauma are possible. It is a serious issue when an anaesthetic is administered to a young child.

Potentially thousands of parents have been left in limbo. For many, there is an excruciating absence of information. This is the real difficulty for them. They want to know how this happened and how hospitals could carry out particular operations at a rate five to ten times higher than the population of the country needed and no one seemed to pick up on it. What Government structures allowed this? Where was the leadership in the hospitals where this happened? What culture facilitated this? Where were Children's Health Ireland, CHI, and successive Ministers for Health during the 15-year period in question? The Department of Health is responsible for all those aspects of our health services. We are asking parents to have confidence in what is happening in respect of their children, yet we cannot tell them what happened to other people's children over the past 15 years. If the idea of the audit is to try to make-----

Thank you, Deputy

-----sure this never happens again, surely there is an urgency in seeing to it that the audit is completed as soon as possible. When will parents know what happened to their children?

I thank the Deputy for raising this issue.

I join Deputy Bacik - I omitted to do so earlier - in expressing my deepest sympathies to the families of Emmanuel Familola and Matt Sibanda and the community in Donegal on the sad and shocking drownings at the weekend of the two young teenagers who were enjoying themselves with their friends. What happened made for a very sad weekend altogether.

In respect of the issue raised by Deputy Tóibín, the audit will not look back 15 years. The audit that is currently being conducted relates to a random, anonymised sample of patients aged between one and seven years for the period 2021 to 2023. Letters have issued from CHI and Cappagh hospital to parents. That is not an audit, however. The clinical audit by the external author is as I have just described. We need to await the completion of that audit. I accept the concerns and appreciate that the absence of completion or information can compound anxiety for parents. That is why it is important that we get the complete audit and that we are in a position to share it with the parents and families, the Oireachtas and the public at large. An action plan will then be implemented and published to deal with that and to work with parents and patients.

I cannot draw conclusions until the Minister and I see the final report. The implications are disturbing, particularly if some of the assertions that were made prove accurate. In other words, if it emerges that they are truthful. There are issues. As I outlined in an earlier reply, changes to practices and protocols have already occurred in the context of a multidisciplinary approach and preoperative assessment. It seems that the latter clearly were not there in advance of this. Cases are being reviewed by a single team of clinicians from CHI and Cappagh hospital before decisions relating to surgery are made. That process has been in place since early March. As stated, in many cases if a child was operated on as far back as 2010, that child would still be getting check-ups through the teenage years.

One would routinely have follow-up until 14 and 15 years of age in respect of such surgeries, and indeed other surgeries as well. That is not uncommon. I favour the completion approach - in other words, getting the full audit out, getting it published and shared and then acting on it.

There are major problems in the health service that the Government can act on now that have led, in part, to the difficulties we are suffering. There is not proper data collection in our health service at the moment. There is not a proper digital patient number in the health service. We do not have a good register of information in the health service. The capture of outcomes is not valued in the health service. We do not track patients in a similar fashion to other jurisdictions to enable us to be able to flag these situations, if they should arise at all. Fixing those particular issues would be of extreme benefit to patients in the system and ensure these issues do not happen in the future. The idea that we would start to track and perhaps even pay hospitals for their activities and outcomes, instead of the manner in which hospitals are paid now, would be beneficial in ensuring that money does not get lost on the front line and get caught up in layers of administration.

My worry now is whether all the parents who could potentially be caught up in this scandal over the last 15 years have been contacted. What is the depth of information they have received? Is it a generic letter or have they been given information specific to their own cases?

In relation to the Deputy's general comments, a lot of huge advances have been made in our health service as well. In fact, through the various layers of management on hospital sites now, we know a great deal of data is being collected in respect of individual patients once they enter a hospital and go in for particular treatment. A lot of information is garnered in respect of every individual patient nowadays. There is a need for further investment in digital health and electronic patient records. In the upcoming national development plan, we are going to allocate substantial funding in addition to that already spent in relation to this issue. This is necessary. The health Vote in 2025 is €25.8 billion.

It is not getting to the front line.

It is getting to the front line.

Not what is necessary.

We cannot be that superficial about it. Of course it is going to the front line.

Some 50,000 operations were cancelled-----

Sorry, we need-----

Please, Deputies.

Some €25.8 billion has been allocated to health in 2025. That is six or seven times ahead of the figures from four or five years ago. The value-for-money thing needs to happen as well, and on another fine day the Deputy will be in here rightly raising those issues. He cannot have it both ways though. It is always a question-----

We will be allocating more to health. We do need to analyse it as well. Separate from the normal funding going into acute and tertiary services, we accept we need investment in the digital health area and we-----

I thank the Taoiseach.