Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank Deputy MacSharry for raising this matter and giving me the opportunity to update the House on paediatric rheumatology services. Juvenile idiopathic arthritis is the most common inflammatory disorder of childhood and I understand that there are more than 1,000 children under the age of 16 in Ireland with the condition. Demand for this national service has grown dramatically in the last decade with patient numbers having increased by almost 400% since 2006. Rheumatology continues to be one of the most rapidly growing services within Our Lady’s Children's Hospital Crumlin and now accounts for the highest number of medical day-care patients seen at the hospital annually.

The Minister for Health is aware that there are challenges in meeting the growing demand for services and that waiting lists for access to paediatric rheumatology services are a particular issue of concern. The HSE is constantly working towards improving access to rheumatology services. The Children's hospital group has confirmed that the two paediatric rheumatology consultants in Crumlin have been taken off the general medicine roster, which has facilitated a greater focus for them on rheumatology services. While nurse recruitment remains a challenge for Crumlin, the theatre closure situation is slowly improving, which will have a positive impact on access to joint injections for Crumlin patients.

In terms of services at Temple Street hospital, I understand that a staff member has recently been accredited as an advanced nurse practitioner in pain and rheumatology and that the hospital intends to utilise this new role to develop a nurse-led clinic to run in parallel with its new patient clinics. The need for a third rheumatologist post is acknowledged and paediatric rheumatology service development will be considered in the annual Estimates process in the context of competing priorities for limited service development funding.

The development of the new children’s hospital and satellite centres provides an opportunity to progress operational integration of the three existing children’s hospital rheumatology services and to plan for the appropriate provision of these services well in advance of the move to the new facilities. The new children’s hospital will provide a wide range of physiotherapy, occupational therapy and hydrotherapy services to children with juvenile arthritis, with clinical examination rooms in the outpatient department and day beds in the day-care unit specifically available for rheumatology. The national model of care for paediatric health care services recommends a hub-and-spoke model in the context of paediatric rheumatology. The new children’s hospital will have a central role in the national model of care. It is proposed that rheumatology consultants will provide outreach clinics to Cork, Galway and Limerick, providing greater local access to services for patients outside the Dublin area.

Representatives from the Irish Children’s Arthritis Network met the Minister of State, Deputy McEntee, in February to discuss services for people with juvenile arthritis. This group also met the CEO of the children’s hospital group in June to discuss current and future services. The Deputy may be aware that the Minister for Health is also meeting representatives from Arthritis Ireland tomorrow to discuss paediatric rheumatology services.

I assure the Deputy that the Department of Health is aware of the challenges facing children with juvenile arthritis in accessing rheumatology services and we are working with the HSE to bring about further service improvements as soon as possible.

See this speech in context