Professor Nicholas Kennedy:

There were various questions about screening. Screening is not going to pick up coeliac disease for an individual until he or she develops it. Even though a person may be born with the genetic potential of coeliac disease, he or she may never develop it. Therefore, screening on a regular basis is not necessary. Population screening has not proven a realistic prospect in any country because of the relatively low pick-up rate. However, specific groups should be screened. That is in recommendations that have been published over many years and it is not being carried out properly in this country. There are recommendations about screening that are scientifically based and they would be better used rather than not.

Senator Burke asked about specialists. Most gastroenterologists are quite capable of diagnosing coeliac disease. I cannot give a figure for the number of gastroenterologists in practice, or the deficit, but I know that the endoscopy services are saturated. If GPs think of coeliac disease and they need an endoscopy to prove it, there is going to be a wait. There are different waiting times in different parts of the country. Paediatric gastroenterology is a particularly difficult area. There are particular areas in the country where the waiting times for adult gastroenterology are longer. A person does not need to be sub-specialised in coeliac disease, but it is true that all gastroenterologists are not equally interested in coeliac disease or equally aware of the large variety of presentations of coeliac disease. It would be better if there was recurrent training for people with gastroenterology practices. This is something that could be addressed through the Royal College of Physicians for continuing professional development design.

The dieticians, equally, need to be trained. Not all dieticians are aware of or efficient in dealing with coeliacs. There is a lot of opportunity, or need, for training in many different areas.