I thank the Deputy. What he raised this evening highlights an issue of concern. I want to give him an update on the patient transport service in County Tipperary. The patient transport service, which provides non-emergency patient transport for some patients in the south-east region, was set up in 2013. It was set up on a discretionary basis by the HSE for the region. Hospitals there were given a budget to provide limited transport for patients to attend other acute services. The cost of providing the non-emergency patient transport service has increased year on year. The cost for providing this service has grown from more than €88,000 in 2019 to more than €127,000 in 2024. Due to this continued increase, Tipperary University Hospital has had to review the eligibility criteria for patients applying for access to the service. The review of the eligibility criteria is aimed at preserving this valuable service in order that those most in need and vulnerable patients can access it. It is important to clarify that patients travelling for radiation therapy and chemotherapy will not be affected by these changes. There are a number of criteria that need to be taken into consideration by Tipperary University Hospital when assessing a patient’s eligibility to access the service, including the patient’s exceptional medical need, patient’s age - 75 years and older - mobility, appointment and so on. The Government fully acknowledges the concern and inconvenience for patients and their families that these changes at Tipperary University Hospital have caused. It continues to accommodate the patients most in need of this service in line with the revised eligibility criteria. The hospital robustly assesses patients’ eligibility and all patients must meet the revised criteria before being approved for the transport. It is actually done through the HSE. The assessment of a patient’s eligibility for the non-emergency patient transport service is determined by the local HSE service, which aims to provide for those most in need of access to this valuable service. The Government has invested significantly in Tipperary University Hospital and the budget for the hospital has increased from almost €81 million in 2020 to more than €122 million in 2025, representing a significant increase of 51% in that time. Staffing has increased by 25% since 2020 from 968 to 1,212. The cost of providing this important service has increased year on year and it is aimed at assisting those most in need.

Sentiment score: 0.19

I thank the Deputy for raising the issue and giving me the opportunity to update him on transport in County Tipperary. The Deputy mentioned the Red Cross, Order of Malta and Civil Defence, and it is important we pay tribute to the great work they do. They are excellent. It is important the Deputy recognised them and that we all recognise them. I assure the Deputy the HSE and Tipperary University Hospital are committed to providing high-quality service in response to local needs. Tipperary University Hospital has reviewed the eligibility criteria for the non-emergency patient transport service so the most in need and vulnerable patients can still access it. Non-emergency transport patient calls are planned for patients who require transport in a special converted taxi or minibus to attend pre-arranged medical appointments and who do not require a stretcher-equipped vehicle. The patient transport service was set up in 2013 on a discretionary basis by the HSE and provides non-emergency patient transport in south-east region hospitals. There is a budget there. I understand the Deputy's concerns. I will go back to the HSE and see whether it can be looked at. I understand there are vulnerable people out there. It is important to reiterate this is HSE-led. I thank the Deputy for highlighting the serious concerns he has raised.

Sentiment score: 0.23

I thank the Deputy for raising this very serious issue. I have spoken to families and I see the concern and hurt. It is important this is raised in the House. A clinical audit has been conducted by an external international expert on surgery for children with developmental dysplasia of the hip across CHI and the National Orthopaedic Hospital Cappagh, NOHC. The clinical audit involved a random anonymised sample of patients aged one to seven years of age who had pelvic osteotomy procedures for development dysplasia, DDH, from 2021 to 2023 in CHI and the NOHC. The purpose of this audit is to assess whether the indications and threshold used to select patients with DDH for pelvic osteotomy procedures were in keeping with international standards of practice. The audit process is at an advanced stage. CHI and NOHC are committed to sharing the findings of the audit once it is completed. An action plan is currently being drafted in advance of the final audit report. This plan includes identification of groups of patients not included in the audit sample but who may be affected by any findings of the audit. A communications plan is being developed to support the publication of the final report and further communications to patients and families. As a patient safety precaution, a single cross-site pre-operative decision-making process for any planned DDH surgery in CHI and NOHC has been implemented. All cases are being reviewed before any decision for surgery is made by clinicians from CHI Crumlin, Temple Street and NOHC. This multidisciplinary team, MDT, commenced the first week of March 2025. In addition, CHI is establishing an expert reference group, including international experts, to develop the standards and criteria for the MDT decision-making process for CHI. An early recommendation from the audit is that, in line with best practice, patients who have DDH surgery should have clinical follow-up at skeletal maturity. This is at about age 14 or 15, when bones have fully grown and developed. Clinical advice is that this follow-up is part of normal post-operative care. Plans are being put in place for patient follow-up in line with good practice and will consider any recommendations on clinical follow-up from the final report. CHI and NOHC have issued letters to all patients and families who have had this procedure since 2010 to provide reassurance and information about the audit and to ensure all potential cases have been included. The total number of letters sent to date is 2,259. The majority, 1,757, have been from CHI, while 502 have been from Cappagh. The number of patients and families involved is subject to ongoing refinements due to clinical review. The HSE funds certain treatments in other EU member states and, as the Deputy knows, we have a similar scheme for the UK or Switzerland, when this treatment is not available in Ireland. As surgery for children with developmental dysplasia of the hip is available in Ireland, financial supports for treatment outside of the State are not available. However, I assure the Deputy that currently all cases for DDH are being reviewed by a single cross-site pre-operative decision-making process before any decision for surgery is made by clinicians from CHI at Crumlin, CHI at Temple Street and NOHC.

Sentiment score: 0.18

I assure the Deputy that the Minister and the Department are taking this very seriously. This is very serious, and we know that. Nobody wants anyone, particularly those children or their families, to be in this position today. I can guarantee that the Minister is very conscious of the concern that will be felt by all the patients and families affected. The audit process is nearly complete and she has been advised that it will be finalised and completed soon. She will then be in a position to comment further once the audit is published. I assure the Deputy that the she is committed to this, as are all of us in the Department of Health. She is also committed to ensuring reform remains centred around putting children and their families at the very heart of this. I do understand. As I said, I have spoken to families in my constituency of Carlow-Kilkenny and I have seen the hurt and pain. I assure the Deputy that the Minister is committed to this, as we all are. We will come back to her with more information. I thank the her. It is important that we work together on this and make sure that the children and families are to the forefront of this, and they will be.

Sentiment score: 0.12