Hildegarde Naughton (Galway West, Fine Gael) | Oireachtas source

I thank the Ceann Comhairle for giving me the opportunity to raise this vital health issue for the west and the Minister of State for attending to answer my question. She is aware that the HSE has indicated that it intends too close the DEXA scanning unit in Merlin Park University Hospital in Galway. I am informed a reprieve has been granted at the eleventh hour, but there is absolutely no plan for the service to move forward; nor are we assured that it will not close in the future.

Ireland has approximately 91 DEXA scanners in use. The DEXA scanner situated at Merlin Park University Hospital is the only scanner not privately operated in the entire west. I am told there is a 20 year waiting list, as it stands, for a DEXA scan in Merlin Park University Hospital. No referral has been processed in three years owing to a lack of staff. Even if the unit is not closed, there will be no reduction in the waiting list owing to the lack of staff. Thousands of euros were donated by the local cystic fibrosis chapter and a charitable bequest was made to purchase the machine. Despite this, the HSE seems to be unable to staff the unit.

Since 2009 GUH staff have educated Irish health professionals on best practice for DEXA and other technologies, running International Society for Clinical Densitometry, ISCD, courses and certification examinations, which qualifications are recognised throughout the world.

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GUH was a centre of excellence for bone densitometry with the only DEXA specialist radiographer in post in Ireland, Professor John Carey, who is the vice president of the ISCD. GUH also established one of the first DEXA centres in the country in 1999 and one of the first fracture liaison programmes. GUH was the first Irish site to gain recognition from the Capture the Fracture programme, which recognises centres of excellence around the world.

While I could continue to recite reasons for the necessity to make and keep this unit properly operational, I think the Minister would agree that any suggested closure is a highly retrograde step. There is enormous public anger building that such a service could be threatened with closure in the west, forcing people again to travel to Dublin for what is a reasonably basic service. I am told that the difficulty with the service appears to be the hiring and retention of qualified staff.

Osteoporosis is one of the most common diseases in the world today, affecting more than 200 million people worldwide. There are no symptoms or clinical features until a fracture occurs. One in two women and one in five men over 50 will experience a fracture related to osteoporosis in their lifetime. A postmenopausal woman's annual risk of fracture is greater than her combined risk of all cardiovascular disease and invasive breast cancer combined. Ireland has one of the highest incidences of osteoporosis and hip fracture in the world. One in three men and one in five women admitted to our hospitals with a hip fracture are dead within a year following the fracture. This is almost double many other countries and well above the UK and EU norms. Many others require lengthy hospital stays in nursing homes, for example.

The cost of treating osteoporosis-related fractures is close to €1 billion annually. Many fractures are preventable by identifying people at risk or diagnosing osteoporosis before a fracture occurs. DEXA scans play a critical role as they are the gold standard in testing to identify people with low bone mass, to diagnose osteoporosis before a fracture occurs and to monitor those on treatment. DEXA is cheap, very safe and very cost-effective. Identifying people early helps them to reduce their risk of fracture. Musculoskeletal diseases are among the commonest diseases in the world and the commonest cause of disability among men and women over 50 years of age in the developed world.

New staff were promised for the hospital's DEXA service in 2013 after a business plan was approved by the Saolta executive committee for a clinical specialist radiographer, a clinical nurse and a secretary. Only the radiographer post was finally approved for advertising nationally after two years. No one has applied for the position and neither a nurse nor a secretary was provided. It is, therefore, clear why there is a waiting list of 20 years.

The cut-off to the staff for musculoskeletal diseases since the implementation of the moratorium on new staff has had an impact on waiting lists and the welfare of patients. I urge the Minister to intervene directly in this case so this vital service is available for the people of the west and I would also like an assurance that the unit will not again be threatened with closure. It makes no sense ending this service for financial reasons or not staffing the unit properly when keeping it. Making it work effectively will save the taxpayer in the long term.

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