Joe Flaherty (Longford-Westmeath, Fianna Fail) | Oireachtas source

I am extremely worried about developments at the paediatric diabetes clinic at Mullingar hospital, where services and appointments have ceased as a result of a farcical recruitment issue. There are 130 children attending this service, with 41 on insulin pumps.

Based on those numbers and international standards, there should be two clinical nurse specialists, CNS, attached to this service. A former CNS was due to retire in May 2019 but remained working on a part-time basis until November 2019 to ensure the service could continue. Unfortunately, it is now almost 20 months since the service has had specialist diabetic nursing support for clinics and for the necessary follow-up support services. Parents are deeply perplexed. Great credit is due to Professor Michael O'Grady who heads up the service and in recent days took the time to issue parents with a four-page document setting out the comprehensive background that has led to the suspension of services.

The case for a replacement CNS was first rejected at national director level in 2019 but, thankfully, following the intervention of Professor O'Grady, that decision was subsequently reversed. As we all know, there is a shortage of nurses qualified to work in the role of CNS in paediatric services. Professor O'Grady again intervened and asked that a background in paediatric nursing be removed from the job specification to broaden the pool of potential applications. Unfortunately, that request and advice was ignored. Not surprisingly, when the post was advertised in December 2019 there were no applicants. So began a new recruitment process which, within the HSE, typically takes six months. Once again, the prohibitive requirement that applicants have a background in paediatric nursing was retained despite the HSE knowing it would restrict the level of applications. Around this time, and in conjunction with the recruitment campaign, Professor O'Grady presented a business case for a second CNS for the service in line with the aforementioned international staffing requirements. That case was duly approved by local management but was subsequently rejected up the line.

Last September, the service was forced to scale back the number of services offered in Mullingar and to close access for new patients, who are now being sent to Dublin for treatment. The service was also forced to suspend the initiation of insulin pump therapy for new users following the departure of one of Professor O'Grady's consultant colleagues. As things stand, a replacement CNS has been approved but, unfortunately, for personal reasons, this person is not in a position to take up this position until 2022 and the service in Mullingar is paused. Children are being referred to Dublin where the service is already at capacity in the three hospitals. Those hospitals will be overwhelmed with an additional 130 patients.

Professor O'Grady has fought valiantly for more than a year to save this service. It is regrettable that the future of such an important service for our region is the subject of a debate here this evening.

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