Tá tuismitheoirí trína chéile mar gheall ar an gcur chuige atá beartaithe don fhiosrú ar Shláinte Leanaí Éireann. Ní mór don Rialtas gníomhú chun dul i ngleic lena gcuid imní agus chun a chinntiú go bhfaigheann an fiosrúchán na freagraí atá de dhíth.

For years, we have heard the harrowing stories of children with scoliosis and spina bifida; children who were failed catastrophically by Children's Health Ireland, CHI, and by the health system prior to the establishment of that organisation, left waiting for operations that could change their lives, living with the fear of becoming inoperable; children who had their hips operated on unnecessarily. They were profoundly failed by the State and successive Governments.

Parents have fought a long and hard battle for answers. They fought for accountability, and yet they were stonewalled at every turn. It took the death of nine-year-old Harvey Morrison Sherratt for the Government to move on an inquiry. Following meetings with Harvey's parents, Gillian and Stephen, the Tánaiste, Simon Harris, and the health Minister, Jennifer Carroll MacNeill, promised an inquiry that would be child centred to provide parents with answers and to deliver accountability.

On Monday, Remy Farrell published his report on CHI and the recommendations for that proposed inquiry and parents feel that they still have not been heard. They are back to square one. They are angry because the period to be covered by the inquiry will have a starting point of 1 January 2019, but the failures of children did not begin on that date. Indeed, they long predated the establishment of CHI.

In fact, Simon Harris made his now infamous promise back in 2017 because at that stage we already had a crisis. He said at that time that no child would wait longer than four months for spinal surgery. Of course, that promise came to nothing and meant nothing as children continued to suffer, so it is not acceptable that an examination of those early years would be excluded from the inquiry because it means that people who are now adults and suffered greatly as children while waiting for treatment before 2019 will be deliberately cut out of that inquiry. That is just wrong.

Parents are also upset that there will not be a detailed investigation into individual circumstances and the treatment of affected children. Instead, the focus will be exclusively on systemic problems. So, the question is: how will this inquiry provide parents with the truth about how their child was failed? For this inquiry to have the confidence of parents, it has to be a process that identifies all failures, including individual failures.

There is also real concern that the majority of the proposed commission of investigation will be held behind closed doors. Of course, some parents will want to give their testimony in private and that has to be respected and accommodated, but remember, many parents are done with closed doors. They were forced to share their children's suffering very publicly, so they want to give their testimony in public, and they want the accountability to be public too.

Does the Taoiseach understand why parents feel so badly let down? Does he recognise and accept that the starting point of 1 January 2019 is totally wrong? Can he tell parents today what he will now do to ensure that this inquiry provides them with the answers they need?

First, I would like to offer my deep condolences and those of the Government and the entire team here at the Oireachtas on last night's very sad passing of our colleague and friend Seamus Carroll, husband of another colleague, Treasa Carroll. Seamus was a very respected member of the usher team and there will be a strong sense of shock and upset among the team throughout the House today. We think of him and pray for him, Treasa and his entire family at this very sad time. Ar dheis Dé go raibh a anam dílis.

Gabhaim buíochas leis an Teachta as an gceist seo a ardú os comhair na Dála inniu. Aontaím léi go bhfuil géarghá ann fiosrú cuimsitheach a chur i bhfeidhm agus a thosú maidir leis an méid a tharla laistigh de CHI chun soiléiriú a fháil ar an gceist iomlán. First, I agree that we need a statutory inquiry in relation to the pediatric services at CHI and particularly following the scoping report, Report on Children’s Health Ireland Inquiry into Spina Bifida and Complex Scoliosis Scoping Exercise, that the Government and the Minister, Jennifer Carroll MacNeill, published on 29 September.

The issues are very serious, and the parents and many others have strongly advocated for an inquiry. My view is that Remy Farrell SC did a comprehensive piece of work in respect of the scoping inquiry. Officials in the Department of Health will now work closely with the Office of the Attorney General on drafting the terms of reference. There will be a call for input from advocacy groups to the terms of reference, and the final terms of reference will then be submitted to the Government for approval.

In respect of a number of issues the Deputy has raised, as she knows, Mr. Farrell recommends a commission of investigation, which is statutory and mandatory and has compellability and all of the core requirements of a statutory public inquiry as per the Act. He has defined four modules: waiting lists, spinal surgery, hip dysplasia and the cohort of children who were not transferred to Temple Street post 2008. There are then two submodules recommended for the module on waiting lists: a personal family statement module and a module on the response of CHI management to waiting list issues.

Mr. Farrell also recommends that the commission inquire into whether the management of CHI was aware of the use or intended use of the non-CE marked springs and surgeries undertaken at Temple Street by consultant A between 2020 and 2022. There is further work in terms of the hip dysplasia and, as I said, children who were not transferred to Temple Street.

One important point is that a commission model can deliver the same core statutory powers as a tribunal and is arguably better suited to the specific subject matter of the inquiry, namely the medical treatment of children. The commission can compel witnesses and the production of documents and will obviously publish a final report.

Mr. Farrell came to his conclusions based on the personal and medical information of children. He feels that this model is the optimum model to handle sensitively the personal and medical information of children. He is concerned, as I would be, about the significant risk that children may be identifiable.

Of course, within a commission of inquiry, there is the capacity for public modules, and that is an area where the chairperson clearly has significant discretion. The chairperson could also have discretion in respect of any issues that arise during the course of the discussion that would have a more historical context, pre-2019. That discretion can be provided expressly to the chairperson to utilise his or her discretion to go back.

I too send our best wishes and solidarity to Treasa and all of Seamus's family on his sad loss. Ar dheis Dé go raibh a anam dílis.

I spoke to Harvey Morrison Sherratt's mother, Gillian, this morning. This is what she said as regards what is proposed: "It's so far removed from what we were promised and expected that we feel like we're back at day one." That is really worrying and it reflects the reaction of many parents. We need to get to grips with this. I am not questioning the essential model that is proposed. I have questioned the Taoiseach specifically on its point of departure. I have put it to him that 1 January 2019 is not the correct date because these problems, issues and really negative experiences, as well as the promises that were made to parents and children, predate 2019. Why in the name of goodness would the Government take that as its point of departure? In the terms of reference, that needs to be corrected. Second, we need explicit recognition that this will be a public process except where parents choose or wish to give testimony in private. Those are just two core issues, among others, that parents are advocating for. Above all else, this inquiry has to, I am sure the Taoiseach will agree, enjoy the full confidence of those parents and families.

Mr. Farrell has said, and I would agree with this from experience, that inquiries work best when they have a defined scope and time. Any inquiry that is absolutely open-ended or has very broad terms of reference can go on for a very long time and I do not believe that is in the interests of the parents, families or children involved. That is why he suggested 2019 to 2025, inclusive, with 2019 marking the establishment of CHI. It is a six-year period. As I said earlier, discretion will be there for the chairperson if issues arise that predate 2019. The chairperson will have discretion to go back and look at those issues. Again, as I said, there will be a call for public input into this and the Minister will continue to engage. There is an issue here. If it is a statutory public inquiry as per the 1921 Act, there is a danger that some may not participate. Quite a number of parents may not want their children to be publicly identified.

You should conclude, Taoiseach.

I have acknowledged that.

I just-----

That has been acknowledged.

That is why we opted for a commission-----

The year 2019 is the wrong date.

On 2019, what I am saying is that the chairperson will be given sole discretion to go beyond or back from that date as issues arise.