A HSE hospital that offers orthopaedic care to extremely sick children could make "a significant dent" in waiting lists, if the referral process were streamlined and more funding made available.
Unlike most public hospitals, the National Orthopaedic Hospital, in Cappagh, does not have an emergency department, which means that patients are unaffected by Covid-19 surges or overcrowding.
A new programme, Cappagh Kids, treats children from age two upwards, but consultants said that slotting this into the complex system of hospital and GP referrals is not straightforward.
Consultant paediatric orthopaedic surgeon, Paul Connolly, said there is great reassurance for families in an elective hospital.
"Patients aren't cancelled," he said. "You know, if a patient gets a date and a time to come in, there will be a bed for that patient."
He estimated the wait time between first assessing a child and the required operation is "within three months" in most cases.
In the last six weeks, his team has completed 34 pelvic osteotomies and 52 day cases. They work with children who have common conditions, including limb-length inequalities, foot problems or bone deformities, as well as scoliosis, if intensive care is not required.
Claire Cahill, co-founder of advocacy group, The Scoliosis Network, said this public access is vital.
"We have a two-tier system for children in Ireland," Ms Cahill said. "If you have the ability to pay for private care or pay for a private MRI, it is very different."
"We'd be very supportive of Cappagh Kids, but we need to see some funding go to Temple Street and Crumlin also."
Ms Cahill met with Eilish Hardiman, the CEO of Children's Health Ireland, and Paul Reid, the HSE CEO, last week. A hospital spokeswoman said plans to tackle waiting lists are "at an advanced stage of approval".
Cappagh also caters for teenagers aged 16 and over. Orthopaedic consultant James Cashman, who is from Cork, works with these teens and adults.
"We are probably the only hospital in the country that managed to keep going with elective work, pretty much unfettered, the whole time," Mr Cashman said, referring to the pandemic.
"As a result, our patient waiting lists are very much under control; our in-patient waiting lists are also very much under control."
Getting referrals from other hospitals is "a challenge", he said, pointing to bureaucratic obstacles, although, as a tertiary referral hospital, they can take patients from anywhere in Ireland, either from GPs or other hospitals.
"Doctors want their patients taken care of — they are happy to come — but it tends to be an administrative difficulty to get them sent over," he said.
They have a good relationship with the Mater Misericordiae University Hospital, and complex patients are referred there from Cork and other areas, he said.
Mr Cashman said Cappagh could benefit patients from counties like Kerry and Donegal, where the closest hospital is already dealing with Covid-19 patients or emergency care.
Cappagh runs five operating theatres five days a week, and Mr Cashman said they have two older theatres that could also be refurbished.
"There is space for us to develop, and there are surgeons to do the work."
Mr Connolly remains optimistic that progress will continue next year for children, saying the more children they treat, the less pressure there is on acute children's hospitals.
“I think we will have made a significant dent on waiting lists for patients,” he said. “We won’t have wiped them out but we will definitely have taken off a lot of patients who have been waiting a long time for surgery.”