Brian O'Shea (Waterford, Labour)

Gabhaim buíochas le mo chomhghleacaí, an Teachta O'Sullivan, urlabhraí Pháirtí an Lucht Oibre ar chúrsaí sláinte as ucht a cuid ama a roinnt liom. Tá suim ar leith agam san ábhar atá os comhair na Dála fé láthair. I have a particular interest in this subject because I have diabetes. In my case there were complications but these related not to sight, but to my nervous system. I developed a peripheral problem in my legs — both legs were damaged and I had to spend quite some time on crutches. I have made a worthwhile recovery since then.

I was diagnosed with diabetes in late 2003 when the problem started to show in my legs. I had a test in 1999 which showed that I was okay and some time in between the condition developed.

Deputy Reilly dealt with some of the issues I meant to raise and I will not go back over those. The issue of children as young as 11 years developing type two diabetes because of obesity is a horrific aspect of our time. It has been put to me that all of those over 40 and over weight should be tested at least once a year to diagnose the pre-diabetes stage. If one catches the pre-diabetes stage one can do a great deal to delay the on-set of the condition.

I am struck by how incomplete and incomprehensive are the figures on the prevalence of diabetes. Frankly, because I have diabetes and people with diabetes talk to one another, it seems there are many more people with diabetes in the country than the figures would indicate. For instance, the Institute of Public Health estimated that at least 141,063 adults in the Republic of Ireland had diabetes, that is, 4.7% of the population. In my view the figure is much higher. One of the members of the diabetes expert group, Dr. Graham Roberts, an endocrinologist at Waterford Regional Hospital, stated that 15% of acute beds could be freed up by preventing the complications with diabetes. It is a significant factor in the health system.

On the issue of diabetic retinopathy with which we are dealing today, I understand that between 3% and 5% of those with diabetes develop sight-threatening retinopathy each year. That is an astounding figure when set against a background, for instance, of the Diabetes Federation of Ireland stating that in Ireland there are 200,000 diabetics, 100,000 people in the pre-diabetic condition and approximately 50,000 undiagnosed diabetics. This is a real problem.

Getting back to the point made by Dr. Roberts, if we can prevent the range of complications, whether cardiovascular, kidney disease related or retinopathy, in the long run the small amount of money needed to roll out this programme would bring a large dividend.

I do not want to delve too deeply into the entire question of diabetes today, but one cannot discuss the retinopathy issue without looking at the range of complications that arise from diabetes. A national diabetes or pre-diabetes screening programme, which would be greatly cheaper than the retinopathy programme, although it would obviously involve testing a much wider population and in that sense would be probably more expensive, would be an investment that would keep many people out of acute hospital beds. This is one of the best ways of reducing health spending by dealing with those who would need acute treatment in hospitals.

Today's statement by the Minister of State, Deputy Wallace, is heartening in as much as it indicates that the funding is available in 2009 to go ahead with the first phase of the retinopathy screening programme. This programme has encountered difficulty previously because of a recruiting embargo. Is there not a recruiting embargo this year? I question whether this scheme will go ahead against the background of the €1.1 billion additional cutbacks in the HSE budget that has been announced. I hope this is not the case because it needs to be done; it is to be rolled out over four years. Like Deputy O'Sullivan, I ask the Minister of State to tell us in unequivocal terms if this is definitely going ahead or will it be one of the cutbacks that are about to be announced as a result of the €1.1 billion in cuts? Will there be an embargo to prevent the recruitment to fill the eight positions that are to be advertised shortly? Will the procurement process for the ICT elements of the programme fall foul of these cutbacks?

The Minister of State's speech was heartening but I have great doubts that it will be delivered on.

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