Go raibh maith agat, a Cheann Comhairle.

Taoiseach, please. Deputy Bacik is on her feet.

Go raibh maith agat, a Cheann Comhairle. I ask that we step aside from the cheap political point scoring for a moment. I want to raise a very serious issue on which I think there is commonality across this House, which is children's health. Specifically, the issue of children who have been suffering with scoliosis and spina bifida who have been failed for far too long by this State. I welcome the announcement this week that an inquiry will be held into the care of these children. This followed a long-awaited meeting between the Tánaiste, the Minister for Health and the brave and tireless advocates Gillian and Stephen Morrison Sherratt. As we know, their son Harvey was born with spina bifida, hydrocephalus and developing scoliosis. Sadly, Harvey died in July this year at the age of nine, eight months after eventually having surgery, having waited years for his operation. I reiterate my deepest sympathies to his family. Deputy Sherlock and I have already done so in person. I commend his parents and the campaigners from other parent groups of children suffering with these conditions who have campaigned and given such powerful advocacy. Many of us will have heard Gillian speaking powerfully on "Morning Ireland" this morning, emphasising two important asks in respect of the inquiry.

The first is that it must be public and the second is that it must be statutory. The Taoiseach and the Government have three weeks now to do right by every child impacted. Nothing less than a statutory public inquiry will do because children are still facing long delays for surgery. In many cases their condition is deteriorating as they languish on a waiting list. We know other children have had unnecessary hip surgeries. None of us will forget the heartbreaking testimony we have heard from parents who spoke about having to listen to children wailing with pain through the night. Families cannot take any more false hope or promises on this.

We all know that, back in 2017, the Tánaiste, the Taoiseach's second in command, committed that no child would wait longer than four months for spinal surgery. Infamously and tragically, that promise came to nothing. We might, indeed, reflect on the fact a child who was ten years of age at the time that commitment was given would now be ageing out of the paediatric system. We have spoken before in this House about the failings at Children's Health Ireland, which are ongoing. Children with scoliosis and spina bifida, in particular, are paying a high price for the inability to deal with spinal surgery waiting lists. This has to be resolved for children who have already been failed, those in the system now and those who will have to wait in future.

The political system has not covered itself in glory on this. Gillian Sherratt says she still has not received answers as to why her son was removed from the urgent surgery list. The orphan report was never published, and nor were the Dickson report and the Nayagam report. As Deputy Sherlock has said, the Government needs to clarify the sequencing of these reports. Another thing to clarify is that back in April, the Taoiseach expressed confidence in Children's Health Ireland, even after a damning HIQA report was published, yet now we learn that CHI is being integrated into the HSE, as we had called for. I am asking the Taoiseach to clarify the following. First, will he commit that parents will have a genuine role in developing the terms of reference of this inquiry? Second, does he agree that it must be a statutory, public inquiry?

I thank the Deputy for raising what is a very serious issue that demands a very profound and comprehensive response. I again express my deepest sympathies to Gillian Sherratt and Stephen Morrison on the very sad passing of their son Harvey. We have to do much better when it comes to healthcare services for our children. I understand the anger and frustrations felt by parents and the children and young people who are either awaiting surgery or are engaged with clinicians and hospitals in respect of their individual cases.

The Tánaiste and the Minister for Health met with Gillian Sherratt and Stephen Morrison yesterday. There were advocates there also. A substantive, empathetic discussion ensued and it was agreed there would be a partnership approach to developing proposals in relation to the structure of an inquiry into spina bifida and scoliosis services at CHI and that a follow-up meeting would happen in three weeks. The Minister wants to reflect and discuss further with the parents on the precise nature of the inquiry. It is important that we give this thought and think it through to get the most effective inquiry. Obviously, we need an inquiry that is transparent and public, can enable us to get to the truth and also can get us to a better situation post inquiry for services for children right now and into the future.

I have supported the decision by the Minister to bring CHI under the HSE. In fact, I would be a strong advocate for that. In earlier exchanges in the Dáil over the past number of months, I have been signalling that the Minister was heading in that direction. It makes absolute sense to me. The original decision was based on three hospitals being brought together under one umbrella but, historically, health has been too institution-centred as opposed to being patient-centred. The move to bring CHI under the HSE is a welcome move to make it more child-centred in this respect, and patient-centred. That is important in my view. One of the reasons CHI was established was the sort of institutional focus - dare I say egos and so on? - that was there. We had the same thing with Holles Street and the maternity hospital. It was the same situation, with things taking too long and the institutions being at the centre instead of what is optimal for the patient, the children and the families. That is where we want to be.

Progress is being made in terms of spinal services.

That needs to be said, but it is not enough.

I thank the Taoiseach.

We need more capacity, both in human resources and physical capacity in terms of ring-fenced surgery and so forth, to enable us to make even further inroads into the waiting lists.

We all agree that the healthcare system, in particular children's healthcare, should be managed according to patient need, and not institutional need. As the Taoiseach has acknowledged, that has been a failing in the past. We welcome his commitment to engagement between the Minister and parents on the shape of the inquiry. Transparency must be at the heart of the inquiry for parents.

Coming back to CHI and the institutional change that has now been announced, back in April our health spokesperson, Deputy Sherlock, called for the HSE to take over the running of CHI. That was in response to the HIQA report detailing myriad failings: a failure to provide care, the use of non-surgical springs and a toxic internal culture. We all recall this. At that time, the Taoiseach expressed confidence in the board. Since then, the Minister and Bernard Gloster have said that they were kept in the dark about aspects of the reports into CHI. We are all wondering what changed the Taoiseach's mind. Why are we now bringing CHI under the remit of the HSE?

I thank the Deputy.

We welcome that, but how can we be confident that this change is going to deliver the transparency and the better, more effective and more patient-centred practice that we all want?

At that stage there would have been newer members on the board. This is important. It is very easy. This is a challenge. The Government has a responsibility to maintain existing services. In the interim, you just cannot announce new initiatives off the top of your head. I signalled very early on the move that has transpired in respect of CHI coming in under the remit of the HSE. In fact, originally - I might have been in opposition at the time - my view was that it should have come under the HSE from day one. To be fair, these are big organisational changes. They are not going to happen overnight because there is a transition process and a lot of work. You have to bring teams with you, and so on. Clearly, we have had more reports since and we have more reports to come. The Nayagam report on governance has still to come, which should feed into any inquiry that emerges. That work can be useful to any inquiry team. We must bring clinicians along. Operations and surgeries will have to continue while an inquiry is under way.

I thank the Taoiseach.

That may potentially create challenges as well.