I will start by acknowledging the Minister's statement. She has dealt with the issues - the surgical mismanagement of children with scoliosis and hip dysplasia in CHI, the sodium valproate injury cases and the Michael Shine abuse case - in an open and comprehensive manner. The Minister has established the process by which senior counsel Farrell and Staines will establish the statutory public inquiries into CHI and Michael Shine, and she has spoken about the ongoing non-statutory inquiry into the harm done to pregnant women and to children who were prescribed sodium valproate. I commend the Minister on her commitment to the ongoing audits of the developmental dysplastic hip review and phase 2 of the Nayagam report. I first want to address the care of children with scoliosis and complex spinal conditions. At the centre of this discussion are children and parents who have endured years of uncertainty, long waiting times and after all of that in some cases have had devastating medical outcomes in a system that would appear to have been dysfunctional with the failure of organisational and clinical governance. The response of the system to families' concerns and distress has in the past been defensive and paternalistic. Their experiences must remain at the heart of how we respond as legislators and policymakers. The inquiries must establish the facts and the consequences of those facts. Notwithstanding due process and natural justice, these inquiries have to be acute in their examination of how and why we arrived at this juncture. Over the past number of years, a series of reviews and investigations have highlighted serious shortcomings within the system. Clinical reviews of complex spinal surgeries carried out between 2018 and 2022 identified extraordinarily high complication rates, including infection rates exceeding 70%, and the need for repeat surgeries in a majority of cases within one cohort. These findings have, understandably, shocked families and the wider public. Further investigations also exposed significant governance failures, including the use of implantable devices that did not have the appropriate regulatory approval, and also shortcomings in oversight, documentation and ethical processes. We must be clear that when failures occur in health care systems, and particularly when they involve children, transparency and accountability are essential. Families and citizens deserve answers and they deserve assurance that lessons are being learned. That inquiry process is now entering a scoping phase, which will help to determine the terms of reference and structure required to fully examine what went wrong and how to prevent it happening again. The terms of reference need to be expansive enough to assuage public concern and focused enough to identify the issues without obfuscation. As we wait for the outcome of these historical inquiries, we must drive forward to improve care for patients currently waiting for treatment. The Minister has driven change with zeal in the past 12 months. Governance issues have been addressed with wider and more inclusive decision-making. Capacity has been expanded through domestic and international outsourcing arrangements. Additional surgical time has been ring fenced. A spinal surgery management unit and ministerial task force have been established to oversee progress. That must be acknowledged but with this investment must come progress, timely access and interventions in a high-quality environment with robust systemic and clinical governance. We must rebuild trust with performance that is audited and transparent. Families must see real change, shorter waiting times, better oversight, safer governance structures and better communication from healthcare providers. We need a healthcare culture that empowers clinicians and staff to raise concerns early, encourages multidisciplinary collaboration and ensures patient safety is always the overriding priority. Most important, the voices of patients and their families must continue to shape the reforms we implement. Ireland is fortunate to have highly skilled clinicians and healthcare professionals who dedicate their lives to caring for children. We must have systems that support their skills and deliver robust, transparent and accountable care. Our responsibility in this House is to ensure lessons from these events lead to lasting change. We have had too many inquiries and too many failures. We owe that to the children affected, to the families who fought tirelessly for service and for answers, and to every patient who puts their trust in our health service.

Sentiment score: 0.19