I welcome the updates on the inquiries and the opportunity to discuss scoliosis and spina bifida. Yesterday, I spoke to parents and advocates and they had three key asks. The first was the independent statutory inquiry, the second was the publication of all existing reports and background information and the third was action now on existing waiting lists for children who are still on waiting lists. What really struck me from that conversation was that I had a conversation with them just after the election and the things they asked for were remarkably similar. In fact, in some instances, they said things had gotten worse and not better. That is deeply concerning. It is crucially important that there is an independent statutory inquiry and there is nowhere left for anybody to hide so we get to the bottom of this and all of the facts, to identify all of the failures and to get answers to the long lists of questions that parents and families have. I would like a commitment from the Minister on the form of the inquiry and what she thinks would be the best form of inquiry. There needs to be a collaboration with the families over the coming weeks on the terms of reference. That is vitally important. In particular, the voice of the child and the voice of young people must be central to this. Many of these are in their late teens or early twenties and their voices need to be heard. They need to be included and not just talked about in the weeks ahead. It is really important that happens not just on paper but in practice. Complex scoliosis was raised earlier and concerns raised with me about a fear among families that would be used to narrow the terms of reference. Parents have said they cannot find anything within departmental guidelines or CHI guidelines defining what complex scoliosis is. There is a real risk that will narrow the terms of reference from the start. In her conclusion, I would appreciate if the Minister could comment on that. One parent said the purpose of the statutory inquiry is to examine systemic issues and systemic failures do not confine themselves to diagnostic labels. That is an important point and maybe one we can tease out. There has been an element of trust being broken between families and CHI and the State. It is crucially important that in the time ahead, that is rebuilt and families feel as included as possible so this inquiry looks at the issues they really want it to look at, such as waiting list categorisation and prioritisation, the decision-making, the variation in access pathways and the disparities in treatment. Crucially, it must get to the facts and identify all of the failures. The other thing families really want is for this public inquiry to release interim reports and not just wait until the end so we are not just waiting years for answers. The families want the inquiry to have reports and a statutory provision requiring that those be implemented in full and that those recommendations be put in place. I would like a commitment from the Minister that there will be ongoing reporting and updates, and things will improve while this process goes on because we have to learn from the failures of the past. The State has gotten this wrong in the past when it comes to tribunals and public inquiries. They have run for years, in some cases decades. They have cost huge sums and they have not got the answers or the outcomes that we wanted. We cannot let that happen here. We need a robust public inquiry that gets us the answers and that changes things. It is crucially important that at the end of this we have better outcomes for families and that we have answers to the long list of questions that parents have. Crucial to having an effective inquiry from the start, all the facts need to be on the table. All the information needs to be laid out and all sides need be furnished with the same evidence and information. That starts by publishing all of the information that is available and publishing all the reports because to date, what has happened is we have relied on whistleblowers. Without whistleblowers in CHI, we would know far less than we do. That is not acceptable. All of the information needs to be put out there. The Nayagam report was commissioned in 2023, yet it still is not fully complete. We learned last month that phase 1 is complete, but it is still not published. Issues were identified in the communication of that and the publication in a Sunday newspaper before families knew about it. One parent told me that they got a notice just 30 minutes before the Department briefing that the briefing was on and that they had not heard. The Minister has said that for legal reasons phase 1 cannot be published but I do not understand how that was not foreseen. Is she confident that the entire report will be published later this year, when phase 2 is complete? There is not just the Nayagam report. There is also the Dickson report, the Arthur Cox report, the Crumlin report that referred to patients as "orphans" within the system and the waiting list management audit, and there are potentially other reports that we do not know about. All of this needs to be on the table. If we are to have that effective public inquiry that we all want, let us get the information out there, let us publish that and let us ensure that there is a level playing field for all involved in this because it cannot be the case that the inquiry and the State have access to documents but parents and families do not. There is a real worry among families that will happen. We need to get a clear timeline on the publication of the waiting list management audit. It was due in November. Then it was due for February. The Minister is saying today it is April. Is that the last deadline we are going to have on this? It seems there is constant delay after delay. Is it the case that CHI is still withholding information? Is that what is holding it up? The lack of information released by CHI is concerning. There is a lack of information about infection rates. We do not know why spinal surgery infection rates are not being published. Parents want to know what the spinal infection rate was for 2024 and 2025, how these figures compare to international benchmarks and whether that data has been independently verified. We need to get as much information out in the open as possible and my experience of CHI is that it has not been releasing information. Officials have been not answering parliamentary questions as frankly as they should and there needs to be more honesty, transparency and accountability. I will briefly mention the audit into unnecessary hip surgeries. My understanding is that the external expert panel review commenced two weeks ago, which is welcome, although overdue. However, there still seems to be some uncertainty about the terms of reference. Last month, the HSE told me: "The Terms of Reference for the External Expert Panel Review have been drafted and are under final review by the Chair and the panel members." Where does that stand? I also believe that the external expert panel review will take 12 months. Can the Minister confirm that whether that is the case and whether the legal issues with the Nayagam review will have any impact on this expert panel’s work? It would be good to know. I refer to the current waiting list because it is crucially important in all of this that we do not lose sight of those who are waiting today and those who are waiting to get access to services. The services need to improve in the here and now and we are not seeing the kind of improvements that we need to see. The CHI seems to be incapable of improving the waiting list. In January, there were 215 children on CHI's spinal service waiting list, unchanged from December last. A total of 128 children were on the active waiting list, up from 108 in December. There were 45 children waiting longer than six months for scoliosis surgery, up from 29 in December. Last year, 534 spinal surgeries were carried out, just 21 more than were completed the previous year. We do not know how many of these surgeries were on the same patient. This is important, because we know that children are returning to theatre for further surgeries. We also know that services are not keeping pace with demand, with 524 patients added to the waiting list in 2025. Therefore, there are real issues with the waiting lists. In relation to the outsourcing, only 19 children have had surgery abroad though outsourcing arrangements with the US and UK since 2024. During that period, 1,047 children have had spinal surgeries, meaning that only 1.8% of these surgeries have been outsourced abroad, despite the availability of €16 million. Last September, the Minister for Health said: "I am not satisfied with the international referral pathways and have lots of questions about why there is a decrease in international pathways and an increase in referrals to Blackrock. I fully accept that going abroad is not viable for many patients and families." Has the Minister got answers to these questions that she was looking for? Do we know what is happening, because, as of 7 November, CHI confirmed to me that 62 patients had been outsourced to Blackrock in 2025? Can the Minister confirm whether the arrangements in place with Blackrock are being examined in the overdue waiting list management audit and whether that will be considered in the report, and crucially, that all the outsourcing arrangements will be examined by the inquiry? Finally, I would like to mention the inquiry into Michael Shine and welcome the progress following the appointment of a facilitator. It is crucial that any ultimate statutory inquiry is victim-centred and adheres to their experiences and needs. Victims' stories must be listened to, and their questions must be answered. Above all, we must ensure that nothing like this can never happen again.

Sentiment score: 0.06