Children’s spinal surgery may be outsourced abroad as waiting list doubles

The number of children waiting for life-changing spinal procedures has nearly doubled since 2019, with the Health Service Executive now being instructed by Minister for Health Stephen Donnelly to explore outsourcing the surgeries abroad.

Despite a Government pledge that no child would be left waiting more than four months for spinal surgeries, there are now 110 children waiting longer than six months.

In a statement, Children’s Health Ireland (CHI) apologised to patients and their families and said there had been an increase in children with complex care needs being listed for orthopaedic spinal intervention.

New information released to Sinn Féin TD David Cullinane shows that in June this year 209 children were waiting for spinal fusion and other spinal procedures at Crumlin hospital. This is the highest figure recorded for the same time of year in the last five years, as 165 were on the same waiting list at the corresponding time in 2022, 126 in 2020 and 93 in 2019.

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In Temple Street, 70 children are waiting for spinal fusion and other spinal procedures, higher than the corresponding time in previous years with 68 waiting in 2022, 54 waiting in 2020 and 47 waiting in 2019.

In the National Orthopaedic Hospital in Cappagh, 12 children were waiting for spinal fusion, up from nine in 2022 and nine in 2021 but down from 18 in 2020.

In total, 291 children are waiting for spinal procedures, nearly double the 2019 figure of 156. The figures include surgeries that may have been suspended, which can happen when further investigation is required or for other clinical reasons.

In a statement to The Irish Times, the Department of Health said Mr Donnelly had asked the HSE to explore outsourcing treatments abroad.

“While this is not a long-term fix, all options need to be looked into given the significant increase in demand.”

Further information released to Mr Cullinane shows that in 2017, as part of an outsourcing initiative, families of children with scoliosis and spina bifida were offered the opportunity to have their child’s surgery abroad. A total of 28 patients then had their surgery performed abroad in 2018.

The department confirmed that no surgeries were outsourced abroad in 2019, despite the success of the initiative.

“There has been a significant increase in activity, resulting in many more patients being treated. In 2022, 509 scoliosis procedures were carried out, compared to 380 for the same period in 2019, the most recent comparable year given the Covid-19 pandemic. This represents a 34 per cent increase and an increase of 47 per cent compared to 2021,” a spokesman for the department said.

“Despite undertaking a substantial number of spinal procedures in 2022, corresponding reductions in the waiting list were offset by significant increases in demand and referrals compared to previous years, with a 30 per cent increase in additions to the spinal surgery list compared to 2021. Children’s Health Ireland advises that this is due to a loss of additional capacity elsewhere and latent Covid-19 demand via increased outpatient activity. The impact of the plan was also affected by challenges in the recruitment of essential staff and delays in capital developments.”

A spokeswoman for CHI acknowledged “that this is a difficult time for individual children, young people and their families who are waiting for treatment. We apologise to patients and their families who are on our waiting lists.”

The spokeswoman said an extra operating theatre would open in Temple Street in September, as well as an extra procedure room and a second MRI scanner in Crumlin which will open “on a phased basis” from this month.

Mr Cullinane said the figures showed “the Government has broken its promise that no child would have to wait longer than four months. We have seen families talking about the experience of their child waiting years in serious pain, only for surgeries to be cancelled. It is intolerable. It seems in terms of increasing capacity and outsourcing abroad the HSE and Government have failed on both counts,” the Sinn Féin TD said.