Rose Conway Walsh (Sinn Fein) | Oireachtas source

I thank the witnesses for their presentations. It is really good to have all the decision makers in the room at the same time. Sometimes it feels a bit like Wimbledon, going back and forth from one to the other. I am really happy they are all here this morning.

I wish to raise the issue of the Versatis patch, which affects 25,000 people. Since 1 December, I have been contacted by many people who are really concerned about this. It goes right through the lifecycle, and includes older people and younger people with arthritis. All of them have one thing in common; they are all in chronic pain. I know the witnesses will have been contacted by a large number of GPs who have said that this is the treatment their patients require. I am baffled over why it has been withdrawn. The message it sends out is that people who have the money will not be in pain but those without the money will have to continue in pain. The alternative treatment for that type of chronic pain is either morphine or paracetamol. The patients are telling me that the paracetamol and other drugs that are given are not working. They really do not want to go on morphine because of all its side effects.

Has the HSE done a cost-benefit analysis of that decision? I am really concerned about the escalating mental health impact even over the short time since it has been denied on the medical card or the drugs refund scheme. The amount of additional money the HSE will end up spending on antidepressants and other drugs that do not work will far outweigh the €30 million being spent on Versatis.

That is outside the cost of the isolation and what it does to patients. For example, I have a 31-year-old constituent with chronic arthritis who is in much pain. She was able to get out and drive around the community, leading a somewhat independent life. She cannot do so now and she is confined to her bed. All the calls I get from her are made from her bed. I am extremely worried about her and other patients left like this.

For somebody like that, the option is to go to a pain management clinic and ask what to do because he or she is immobilised. People must ask how they can be helped. The patient I mention has been on the waiting list since July 2016. When Vertsatis was no longer available and she contacted the relevant people, she was told it would be at least another 15 months on the list. There is nowhere to turn for these patients other than their GPs. Those GPs are advocating in the best way they can. What is the process for looking at this again? I know there are other drugs. The witness might tell me this was designed especially for people in the aftermath of shingles but there must be other drugs in the system that treat multiple conditions. This is one such drug.

My second issue concerns physiotherapy services. In Mayo - I am sure it is not unique to the county - there are people waiting months, including children with disabilities. I am glad to see the man with a plan here and what he is working towards. At this moment we have children with disabilities who are supposed to be getting clinically assessed for weekly physiotherapy but they have not had physiotherapy since September. It is a fact and there is no way to hide it. What plans are in place for that? I have asked colleagues to submit a number of parliamentary questions in this regard. In Erris the physiotherapist is back again and I hope that will somewhat reduce the list within that confined area. It is a serious problem that must be examined now.

I must also ask for an update on Translarna. The Minister has met Lewis Harte-Walsh and I thank him for that. He knows how time-sensitive is the approval of Translarna. I am not sure where Mr. Connaghan has come from or the jurisdictions in which he has served. I was trying to pick up the accent but whether it is Scotland or any of the other 22 countries, he would know Translarna is approved there, albeit conditionally in some parts. We need to have it approved here quickly. There are only five children who need this drug so we are not talking about huge amounts of money.

The Castlebar primary care centre is an excellent service and I look forward to increased services within that. There is an issue around Castlebar and I ask for it to be taken into account when planning the other primary care centres. We should not be in a position where the primary care centre physical structure is built and we then start looking for staff. We should do it much earlier, possibly at the planning stage. There is also an issue with transport. The primary care centres must be careful of working in isolation. There is a primary care centre outside the town but people on very low incomes and dependent on social welfare may have to pay for taxis to get in and out from those centres. It is cost-prohibitive. There must be a process with the community transport system to help patients get in and out and make the centre accessible.

Could I get an update on staffing for Coolock, Darndale and Dungarvan? The Taoiseach's maiden speech mentioned that everybody would looked after from Dungarvan to Doohoma. I would also like an update on Limerick city, Boyle and Westport and Claremorris in the Mayo area. I am concerned that if no new staff is being put in place, staff will be dragged in from surrounding areas. That is fine but I am really concerned about the surrounding areas, again because there is no public transport. I cannot see how this will increase capacity within these communities unless there is additional staff. Perhaps we can get an update.

I must ask the Minister again about a case that I raised with him in 2016 concerning a man waiting for a spinal operation. He is still waiting for it. He had an operation but could not have another one because of capacity issues in Galway. He is now in the Mater hospital.