2026-07-01

Concerns have been raised in Cork regarding access for children to MRI scans in circumstances where a general anaesthetic is required. My understanding is that there were outside people coming in to do this work. That all stopped last year. The waiting list has grown substantially and, as a result, there is a concern. Eight consultants signed a letter advising of their concerns. The question now is how we are going to resolve this issue. Planning was granted for a new paediatric unit at Cork University Hospital, CUH, in 2022. Work on that project has not commenced. Access to certain procedures for children is being restricted as a result. My understanding is that people from outside were being employed to do some of the work involved but that this has stopped. The other issue that is of concern relates to the outpatient unit that is due to open at Curraheen and whether there will be sufficient staff to operate it. What happened in this instance was that external firms were brought in to do the work. That has stopped, but no additional staff have been taken on to do the work that was being done previously. I have no problem with work being stopped in circumstances where outside contractors were doing it. However, I do have a concern about waiting lists growing substantially. There is also a question in relation to paediatric services in Cork. There is now major concern about how long a child will have to wait if they need an MRI scan in circumstances where he or she needs a general anaesthetic in order for the scan to take place. The letter to which I refer states that the waiting time could be as long as four years. That is really not acceptable at this stage. What can be done to make sure that there is not an unreasonable waiting time when it comes to getting access to these scans and to resolve the other issues the consultants involved have raised? I hope those issues can be resolved by the HSE, the management at the hospital and the people working at the coalface, namely the consultants, general doctors and nurses. That needs to be looked at. When will action be taken on this matter?

I appreciate the Deputy raising this matter. I feel as though I may be operating in something of a vacuum here. I might follow up with the Deputy in order to discover who exactly are the people who signed that letter. It is not a letter I have seen. It may have been sent to my Department, but I have not seen it yet. I certainly want to discover who they are and see the issue they are raising. Due to the fact that I am operating in a bit of a vacuum, I have to rely on information on what is happening at the same time. As the Deputy knows, we ceased third-party insourcing as of yesterday, 30 June. He stated three times an external group of people were coming in to CUH to do some diagnostic work, which is exactly what we were seeing with third-party insourcing. I can fairly infer that what the Deputy is describing may be a consequence of the ending of third-party insourcing of the kind that those on the health committee found so problematic. I do not know if it is the case that this was a third-party insourcing arrangement that has ceased. The Deputy is not sure. We can follow up and check the names.

I will reply to the Minister in my next contribution.

Sure. What I would point out is that the south west has a more than ample number of ample staff at the moment. It has recruited 617 people this year alone, which is a nearly quarter of all the people who have been hired by the HSE this year. The HSE has recruited 2,700 people overall. As stated, 617 of them have been appointed in the south west, which is one of six regions. Those in the south west have dramatically increased their recruitment. They are still very high when it comes to agency staff and overtime, which means that there has been no lack of people available to work in the south west. As already stated, third-party insourcing ceased yesterday. I am not suggesting that this is directly related, because I do not have that information. However, some of that third-party insourcing in CUH related directly to diagnostics. The letter to which the Deputy referred relates to a diagnostic concern. That must be sorted out because the people who must not be prejudiced by what is happening in this regard are children who are awaiting diagnostic scans. The issue around the letter and the timing of everything certainly raises more questions for me to interrogate and investigate. As I said, the south west has recruited many more people than other regions. Dublin Mid-Leinster has recruited about 300 people, so the south west is well advanced in terms of its recruitment and the availability of people to do this work. We must figure out exactly what has happened and how that may be managed, but this does raise quite a number of new questions for me to investigate. The Deputy asked about developments relating to paediatric care at the hospital. The Government has invested significantly in paediatric care in CUH. Phase 1 of the paediatric department has been operational since 2017. Phase 2 will focus on the paediatric inpatient unit and will deliver 82 much-needed new and replacement inpatient paediatric beds. We continue to invest in and support that. It is very important that we get to the bottom of the situation relating to MRI scans.

My understanding is that the eight consultants signed the letter. It was sent to the head of the HSE. They expressed serious concerns to the effect about delays and about the consequences of those delays. The headline of the article I read, and in respect of which I did some further checking, was "Doctors at Cork hospital call for 'immediate action' to mitigate risk of 'preventable paediatric deaths'". A headline like that will cause serious alarm for parents of children who are waiting.

I could not agree more.

I raised this matter in order that assurances can be provided and that people can get access to care in a timely manner. A question still arises as to why, previously, there was outsourcing or there were people coming in to do this work privately. That practice has now stopped. The argument being put forward by the consultants is that no additional staff have been taken on to deal with the vacuum that has been created and that, as a result, the list is going to grow and people are going to be waiting longer. In relation to MRIs, where a concern is expressed by a GP or a medical consultant in relation to a child's health, if there is any delay, there may not be any going back because the treatment was not provided in a timely manner. Eight people at senior level would not sign such a letter unless there are genuine concerns about the waiting time. Whatever the issue is when it comes to providing care for children, it needs to be resolved. I fully understand that we are putting a huge amount of money into the new national children's hospital, and rightly so, but it is important that areas outside of Dublin are not left in limbo as regards people getting access to the care that is required. As a result, I ask that this issue be looked at. The Minister may not have all the answers this morning, but she might come back to me on the matter.

I certainly will, and I could not agree with the Deputy more regarding the importance of resolving and identifying the issue and of making sure that children are getting the diagnostic scans they need. I could also not agree more with him regarding the importance of investing in paediatric care outside of Dublin. That is very important, and it is important to articulate it here this morning. I am in agreement with the Deputy in every possible way in relation to this matter. I just want to figure out exactly what is going on and how this has come to be. I should have said earlier that there are 269 children currently waiting for an MRI under general anaesthesia at CUH. Having an MRI under general anaesthesia requires a nurse and an anaesthetist as well as a radiologist. It is a more complicated team. I am aware that the south west has recruited ahead of everyone else. If there is a challenge in terms of where the resources are, it is one we have to figure out. Certainly, that area has recruited more than anybody else, so there should not be this issue. It may be that deployment is more the issue than availability. It is for me to figure that out and to get back to the Deputy. He is correct to raise the issue here today because we do not want children discriminated against in this way. CUH has invested in a Smileyscope distraction system, which works to develop children's tolerance - where possible; it is not always possible - of MRI without anaesthetic. Instead of sedating children, two play therapists distract and keep them occupied during the MRI. We do not want to have to sedate children where it is possible to avoid it. Eight children have successfully completed the MRI through that approach without the need for general anaesthetic. I thank the Deputy for raising this really important issue for children's care, including as it relates to resource deployment. I assure him that I will figure out what is going on and get back to him on it.

I thank the Minister.