The Tánaiste knows only too well the saga of Children’s Health Ireland, CHI. Children with scoliosis and spina bifida were left waiting years for care. In many cases, they never received it. There were unapproved, non-medical springs implanted in children’s backs, hundreds of unnecessary hip operations and mismanaged waiting lists. These are the so-called Crumlin orphans, children with complex needs who were ignored by the system and left with poor care. Promises were broken time and time again. There has been report after report showing mismanagement, a lack of transparency and our most vulnerable children being failed. Some reports have been published, some have been leaked but more are hidden or buried. Too often, families were the last to know, finding out through the media instead of from CHI. Broken promises have led to preventable deaths, lifelong harm, injury and disability. Trust between families, advocates and the system could not be lower. It is completely shattered.

The Tánaiste’s own broken promise that no child would be left waiting more than four months for scoliosis surgery is a very painful memory for these families. There are still 30 children waiting longer than six months for surgery, and the waiting lists are just as long as they were a year ago. It is because of those litanies of failures that families and advocates demanded an independent statutory inquiry, something the Government agreed to. We hoped it would be child centred, that families would be equal partners and there would be no hiding place for wrongdoing. This is what families and advocates say they were promised by the Minister and the Tánaiste.

A group representing over 900 families affected by the scandals at CHI has raised serious concerns about the scoping exercise to determine the terms of reference. Despite promises from the Government that the truth and their children would be put first, advocates now say the Minister for Health, Deputy Carroll MacNeill, has not remained true to her word and the process thus far has been anything but child centred or based on the needs of the families involved. They say documents are being hidden from them and unpublished reports are to be excluded. They say they are being stonewalled by a Minister who has not responded to their concerns. Families and advocates want one thing: to uncover the truth of what happened to their children and make sure it never happens again. That is something we should all want. There should be no hiding places, no fear of what may come out and no resistance to working with families and advocates.

This inquiry must be about truth, accountability and transparency. Any fit-for-purpose inquiry must also fully include families. It must have their faith and confidence. We can have that child-centred inquiry. It is not beyond us to get this right but it means the Government must listen to these advocates who have campaigned tirelessly for over a decade for their children and shown us the way forward. The only way to build trust is to work genuinely and in collaboration, with full openness and no attempt to limit, conceal or control access to information. The only motive should be to support these families and their children to establish the facts. My question today is simple: will the Tánaiste listen to these families? Will he act on their concerns and make sure they can trust that this inquiry will not just become another broken promise?

I thank Deputy Clarke for raising this important issue. At the outset, everyone on all sides of this House recognises the significant challenges, stress and worry that families face when they have a sick child, and the very significant challenges families face in relation to paediatric spinal services. There has been and continues to be ongoing additional investment in this area. A total of €30 million has been allocated to help tackle spinal waiting lists, including a ring-fenced theatre, additional orthopaedic surgeons, improved GP referral pathways and additional outpatient clinics. Indeed, I saw that a total of 556 patients attended Saturday clinics since the beginning of 2025. Opening up access at weekends is an important reform. When it comes to outpatients, we see now that the average wait time has fallen to 4.4 months, compared with 7.7 months in May one year previous. A total of 99.2% of patients are now waiting less than 12 months for their outpatient appointment. When we look at inpatients, 200 inpatient procedures have been completed so far this year and the average wait time has fallen from 5.3 months in May 2025 to 4.6 months in May of this year. The Deputy is entirely correct, however. The Minister and I, as well as everyone in the Government, knows there is a lot more that we want and need to do in this area.

There has been a number of concerning revelations over a sustained period of time in relation to CHI. That is why the Minister for Health, Deputy Carroll MacNeill, has correctly taken the decision on the direction of travel in terms of replacing and subsuming CHI into the HSE. That is good from a governance point of view. It is an important step to take. The Minister has the full support of all in the Government in that regard. That is an important factor with regard to the issue of trust the Deputy raised. I accept that as well.

We have also seen recently the work the Minister and the former CEO of the HSE commissioned, whereby audits are to be carried out on waiting lists and concerns in this regard. We saw that published very recently. One of the things that is most striking when reading those audits is the poor communication time and time again. We agree fully with the Deputy that, often, issues in the health service can be added to or amplified by poor communications and families not feeling that they are at the centre of the information flow. That is why I welcome the Minister’s decision to ask CHI to put in place a patient co-ordinator. So much can be improved when there are good, open and transparent lines of communication. I think the Deputy referenced that in her question.

The Minister and I have had sustained engagement with advocate groups. The Government agreed to establish a scoping inquiry. It is important for that work to be carried out. The eminent Mr. Remy Farrell SC has been appointed to do that work. He has been engaging with families, advocacy groups and consultants. I know he wishes to conclude that work shortly. The Government will also want to balance that with making sure that everyone has the opportunity to have their say and engage with him. I encourage everyone to engage. I say that respectfully. We have appointed an eminent and serious senior legal figure, without prejudice, in order for people to engage in that process and have their views heard. That will play an important role in shaping the terms of reference and the next step.

We all want the same thing, Deputy. We all want a situation where we have an inquiry that can examine the issues that have arisen and, as the Deputy said, ensure they do not arise again. We all seek to build a health service that can serve the needs of all of our children. We have that structure in place. The Government is committed to it. Mr. Remy Farrell SC is very committed to doing a good job. I encourage everyone to take the opportunity to have their say and input. The Government will respond in kind.

What I find striking is the letter from the spina bifida and hydrocephalus paediatric advocacy group that states clearly, "We feel we have no other option but to withdraw from this scoping exercise". I find that deeply concerning. Trust is not built on promises; it is built on keeping them. These families were promised a child-centred, codesigned inquiry. Today, they say very clearly that promise has been broken. If the Government has nothing to hide, then let it hide nothing, honour the commitments that were made to these families and publish every unpublished report.

Every document and every unanswered letter sends the same message to these families that protection of the system matters more than uncovering the truth. Give families access to all the Children's Health Ireland, CHI, reports so that they can at least engage effectively. Let them see what happened. Let them see the truth and how it is that this came about because otherwise the Tánaiste cannot say that this will never happen again. They want this to never happen again. It is not too late to do the right thing. This is one issue where the Tánaiste needs to hold to his promises.

To be clear, the Government is fulfilling its commitment to this House and the decision that it took to appoint Mr. Remy Farrell SC to carry out a scoping inquiry. There are a number of advocacy groups. There may be eight advocacy groups in this space in relation to children's paediatric spinal care and many are engaging with Mr. Farrell SC. I would encourage genuinely everybody to engage without prejudice to provide information, ask questions and raise concerns that they would like Mr. Farrell SC, as an independent external senior legal figure, to consider and to report back to Government. That is a good way to proceed.

We also extended the terms of reference to include the hip dysplasia group. This is not a question of Government. This is a question of getting to the answers in terms of CHI, the legitimate and important issues that people have highlighted so that the Minister is then empowered to take the appropriate decisions that she wishes to take to deliver a world-class children's health service, with a new national children's hospital, with all the additional resources going into children's health and with the reforms that she is leading on and the benefits we are seeing now around those additional resources, such as the Saturday outpatient clinics and the likes. We want everybody to engage here in good faith with Mr. Farrell SC. We want to make progress on this.