Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I, too, wish to apologise to our guests for the small number of members in attendance.

Our guests made a common point in all of their presentations on the need for a national pain management strategy. They cited a number of international models of practice. I presume the case for such a strategy has been made. I will not direct a question at any one of our guests because each of their respective contributions was complementary and all referred to the single objective of a national strategy being developed. Would it be possible for one or more of them to indicate where the case for the latter rests at this point? What is the reason for the inaction of the Department of Health or the HSE or for their failure to find a driver of this proposition? Will our guests provide a sense of the barriers and obstacles and indicate how the committee might assist them with the objective of having a national pain management strategy developed and, most importantly, implemented?

I thank Dr. Fullen for her contribution. The Irish Pain Nurses and Midwives Society is relatively new. I had not been conscious of its existence, for which I apologise. I am married and my wife and I have five children. I am aware, because I was present on each occasion, of what she went through during the births of all five. In the light of the definition of chronic pain, particularly in the context of the period of time to which Professor O'Connor referred, would it be possible for our guests to give a layman such as myself a sense of the direction midwifery, nursing care and obstetrics are taking in this regard? I am trying to appreciate chronic pain in the context of the definition provided and the period of time after which pain is classified as chronic. Will our guests comment on this matter in order that I might obtain a clearer understanding of the definition and how it is applied?

Dr. Keaveny referred to the need for improved pain management and the appointment of a lead clinical director for pain services. Is he referring to someone who would operate at national level and within the structures of the HSE? Would that person have oversight of pain management services throughout the acute hospital system? I suggest we are referring to an individual. Will Dr. Keaveny elaborate on this matter and provide a clearer picture of that for which he is arguing?

Dr. Keaveny stated, "We should consider a pain strategy based on the Australian pain strategy." Mr. Lindsay and one or two of our other guests also referred to the experience in New Zealand and Australia. Dr. Keaveny mentioned the huge social and financial cost of chronic pain. A greater understanding of the latter would act as a driver of an increasing realisation and awareness of and, I hope, encouraging some movement in addressing the problem. I must admit that I am a service user and that I am aware of the dreadful and debilitating reality of chronic pain.

It is sad that we must talk in terms of social and financial costs, particularly the latter, as a driver when, for me, the reality of the debilitating chronic pain with which the individuals and their families have to cope should be the key driver.

Regarding Professor O'Connor's contribution, I note from the Irish experience and the Europe-wide survey that approximately one in five people in the general population report having chronic pain, some for up to 20 years. That seems to be a huge number of people. I must admit that I would not have been conscious of that, and there are different degrees of pain. Of the people who report having chronic pain, I imagine they are not all on the one page in terms of that experience. Professor O'Connor might briefly expand on that.

The Irish Pain Society has asked that the members of the committee report on this issue to the Minister. I propose that we do so, and that the collective of the five written contributions go as a joint submission from this committee to the Minister, Deputy James Reilly. It is a practical step we can take. I have no doubt colleagues will fully support that proposal.

On the impact of severe chronic pain on all aspects of the lives of its sufferers, I will share a small comment. My mother is advancing to her middle 80s and has early-onset Alzheimer's. Because of that circumstance I hear her not only once but repeatedly say, "But thank God I have no pain." She says it over and over again. Jokingly, I have quipped back "But you are," and she takes it in good stead.

Regarding Mr. Lindsay's contribution, the subtext of the decision of the Medical Council of New Zealand to recognise pain medicine as a specialty in its own right is that this is not the case here and it is something we need to have. I have no doubt that if any of us as members of this committee had chronic pain as part of our daily reality, we would take no convincing whatsoever. It is always the case that none of us knows what is ahead of us at any time, and now is the time for us to act. I very much welcome and thank each of our guests for their contributions. I hope that our subsequent efforts will be complementary to the achievement of a real advance in this area.