Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this serious and important issue. I am addressing the Dáil on behalf of the Minister for Health, Deputy Stephen Donnelly, regarding the unacceptable delays in appointments for children with rheumatism and those with Down's syndrome also.

First, the Minister and I sincerely regret that children can experience a long waiting time for rheumatology treatment. The Minister is conscious of the burden this places on them and their families. In response to the Covid-19 pandemic, the HSE took measures to defer most routine elective scheduled care activity. This was to ensure patient safety and that all appropriate resources were made available for Covid-19-related activity and urgent, time-critical work. This decision was in line with the advice issued by National Public Health Emergency Team, NPHET, international guidance and the national action plan published on 16 March.

Children's Health Ireland, CHI, at Crumlin has advised the Department of Health that during the initial phases of the Covid-19 pandemic, all face-to-face hospital outpatient reviews and most planned diagnostic tests were deferred in response to the pandemic. CHI at Crumlin has recommenced the majority of outpatient and diagnostic services, albeit at a reduced number in light of the need to ensure appropriate physical distancing. Patients are being seen by consultant rheumatologists in CHI's outpatient suite, including urgent patients and those who were deferred during the early phases of Covid-19. However, there is a significant waiting list at present and there is an increasing volume of referrals. In 2019, there were 1,705 referrals to CHI's rheumatology service, compared with 1,055 in 2018.

At the same time, there is an improvement in the numbers being seen. Even with the disruption caused by the pandemic, the rheumatology service has seen more outpatients in this year to date than it saw in 2019. Some 1,338 have been seen so far this year. This is in part due to the 2019 and 2020 investment in medical, nursing and healthcare and social care professionals, who have developed additional initiatives such as musculoskeletal physiotherapy led triage and clinics, further development of transition services with St. Vincent's University Hospital nurse-led clinics and speciality clinics for those patients on specific treatments such as disease-modifying anti-rheumatic drugs, DMARDs, biologies. CHI advises the rheumatology team is also seeking to run additional clinics in CHI at Connolly Hospital in 2021 within the current resources. It has further advised there is an active recruitment campaign for an additional rheumatology consultant under way. The closing date for applications for this post is tomorrow, 11 December. It is anticipated that the recruitment of a suitable candidate will allow an increased number of patients to be seen and diagnosed, with treatment initiated as part of a comprehensive rheumatology service.

I assure the Deputy and patients that the Minister is committed to ensuring that children have access to the service they require. The Department of Health will continue to work closely with the HSE in this regard.

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