Maria Byrne (Fine Gael)
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I thank the Minister of State for coming to the House to discuss this important issue. I am a member of the Oireachtas all-party committee to do with diabetes. It is an area I have a special interest in because I know many people who are patients under the diabetic services, and I hear from them regularly.

While I note there were isolated cases in Mullingar hospital recently, there is a fear within the services and within the different CHO areas that there will be a knock-on effect. Insulin pumps have been a life-changing experience for people with diabetes, especially for children because many are involved in activities, sitting exams or going to school. The pump picks up when a person's sugar levels are low and it automatically gives them an injection of what they need to sustain themselves. As a result of the embargo to do with staff shortages or if a diabetic nurse is out sick or off on holidays, there is nobody there to look after the children or to advise. These diabetic nurses are so important across all CHO areas. It has been seen across some of the hospitals that there is no staff to actually put in the pumps and to look after the children with the pumps. What plans do the Government and the Department of Health have going forward to deal with this issue?

Colm Burke (Cork North Central, Fine Gael)
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I thank the Senator for raising this important matter. Diabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition. If not well managed, it can lead to debilitating complications. Management is required across the entire spectrum of healthcare delivery, including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care. In recent years, there has been increasing demand on paediatric diabetes services linked to a nationally recognised increased prevalence of childhood diabetes. Insulin pump therapy supports these patients to improve their glucose control and improves their quality of life.

To support insulin pump users, a diabetes team needs to have a level of staffing that includes dietitians, diabetes nurse specialists or advanced nurse practitioners, and a consultant.Where a vacancy arises within a diabetes team, the HSE endeavours to recruit an appropriate replacement as soon as possible. Where there is a loss of staff within a diabetes team, certain elements of service may be temporarily halted to ensure that the insulin pump service can continue to be delivered in a safe manner, pending recruitment of a suitable replacement. It is acknowledged that hospitals are facing challenges, given the national and international scarcity of specialist trained staff, and where possible, the HSE redeploys staff to ensure continuity of a service.

The Government is committed to improving services for those living with diabetes. As part of budget 2023, the Minister for Health, Deputy Donnelly, allocated funding to commence the development of a national diabetes registry. A multidisciplinary HSE and academic team with clinical, public health and IT representation commenced work on phase 1 of this multi-year project last year. As part of budget 2024, half a million euro in further funding has been provided for the development of this important initiative. With a diabetes registry, the HSE will be better able to track the prevalence of the condition and improve planning for future services.

Officials in the Department of Health are engaging with the HSE diabetes clinical team in consideration of the future development of diabetes related services. As part of this work, the HSE is conducting an examination of diabetes staffing levels across the country. This will help to identify and address gaps in diabetes services.

In addition, budget 2023 provided funding for the commencement of a national paediatric audit of type 1 diabetes. This audit will highlight areas of good practice, identify service deficits and regional disparities and promote data-driven resource allocation. Due to the ongoing recruitment pause for senior administrative grades, a revised proposal has been received from the National Office of Clinical Audit to continue with this important work in 2024.

I wish to say, in conclusion, that HSE staffing levels have increased by more than 45,000 since December 2014. Last year alone, an additional 8,500 people were recruited and are working in the HSE. There is a substantial increase in staffing levels right across the board and that is important to acknowledge as well.

Maria Byrne (Fine Gael)
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I thank the Minister of State for his comprehensive reply. I welcome that funding was provided for the start of the national diabetic register because it certainly is something for which I have asked here in the past. It is needed because it shows the roadmap as to where the issues are and how people are being dealt with. It is important that we move to a model whereby everybody, where possible, should have a diabetic pump, especially those who have type 1 diabetes. We must move towards that as quickly as possible because it is a life-changing experience for people.

Certainly, I believe we need to invest in diabetic nurses because they have the time and are able to advise the patients as to what their issues are and they often prevent them from having to go to hospital. I believe it is a condition in which a lot more investment is needed. I welcome that there has been a lot to date, but more to come.

Colm Burke (Cork North Central, Fine Gael)
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I apologise to the Acting Chair, as I did not say at the start that I was taking the Commencement matter on behalf of the Minister for Health. Likewise, the previous Commencement matter was taken on behalf of the Minister for Education.

To conclude, the Minister for Health is aware of the needs of the diabetes community and the challenges faced by those living with the condition. Type 1 diabetes in childhood is a complex condition and if not well managed, can lead to further complications for these patients. In recent years, there has been an increased prevalence of childhood diabetes. This, in turn, has led to increased demand on paediatric diabetic services. Budget 2023 provided funding for the commencement of a national paediatric audit of type 1 diabetes. This audit will highlight areas of good practice, identify service deficits and regional disparities and promote data-driven resource allocation.

Unfortunately, the exact prevalence of diabetes in Ireland is not known. The establishment of a national diabetes registry is currently in the early stages of a multi-year project. A national registry will provide much needed data to understand the prevalence of diabetes in Ireland and to improve planning for services for people with diabetes into the future. Officials in the Department of Health and the HSE are currently engaged in working towards future development of related services.

It is important to highlight this issue. It is a challenging area and it is important that we put in place the infrastructure at a very early stage and especially that it is well managed for all age groups but for young people in particular. It is important that we put the funding into it.