Cormac Devlin (Dún Laoghaire, Fianna Fail) | Oireachtas source

I welcome the opportunity to examine the Government’s investment in healthcare today. This debate needs to be framed in the context of the unprecedented increase in funding for the health service, going from €19 billion in 2019 to over €24 billion today. Inflation has caused massive challenges across society and this is no different for the health sector. The Minister, Deputy Donnelly, and the Ministers of State, Deputies Butler and Naughton, are all well aware of these challenges and they have made tremendous efforts to secure funding and to prioritise front-line healthcare. As chair of the all-party Oireachtas committee on diabetes, I would like to turn to the Government’s investment in diabetes services.

Under this Government, there has been a significant shift in both the quality and delivery of diabetes care throughout the country. More patients are being provided with care in the community and at an earlier stage, which is critical. Patients with diabetes who have a medical card or GP visit card have, under this Government, had access to the chronic disease management programme in GP settings. Under this programme, patients with diabetes have four planned appointments with their GP or GP nurse over the course of a year to monitor their condition on an ongoing basis. These appointments are critical to monitoring patients and identifying any changes needed to the management of their condition. This policy empowers patients to take the lead in the management of their diabetes.

With the expansion of eligibility for GP care to an additional 500,000 people under budget 2023, the number of people who can access this programme has increased significantly. Where necessary, GPs can refer patients with diabetes to the enhanced community care chronic disease teams. These teams provide specialist services, including podiatry, dietary advice and, if necessary, access to consultant-level care in the community. Combined, these programmes mean that patients can access the care they need close to where they live, without needing to attend a hospital setting in the majority of cases. Research into the chronic disease management programme has shown that more than 90% of patients with chronic diseases, including diabetes, are now successfully managing their conditions in community settings. This is a stark contrast to where we were a number of years ago.

The Minister launched the diabetic retinal screening programme in June. The programme is for people in Ireland with diabetes and who are at risk of retinopathy. Diabetic retinal screening is available free of charge once a year to all patients over the age of 12 with diabetes, regardless of eligibility status. Screenings are offered annually for the first two years, and then every two years if no retinopathy is found. Screening is a way of detecting any changes to the small blood vessels in the lining at the back of the eye. Diabetic retinal screening allows patients early diagnosis of diabetic eye disease, which can reduce or prevent damage to sight.

Budget 2023 provided resources for all women, whether or not they are General Medical Services patients, who have suffered gestational diabetes or pre-eclampsia to have access to ongoing diabetes screening through the course of their lives. Access to this service is commencing this month and it will be delivered as part of the national chronic disease programme in general practice. This service will give women who need it access to an annual screening for diabetes, as the risk of developing diabetes is increased in women who suffered gestational diabetes or pre-eclampsia. Women who develop diabetes will have access to the full GP chronic disease management programme, which involves four planned visits per year as I outlined a few moments ago. These women will also have access to the enhanced community care chronic disease programme teams when required.

As chair of the Oireachtas committee on diabetes, I have been working closely with diabetes practitioners and specialists, including Diabetes Ireland. A key ask is the establishment of a national diabetes register. I have put on record previously, and it is very appropriate to do so again today, my appreciation of the Minister, Deputy Donnelly, who has spearheaded this and has prioritised it over the past 12 months. He has been a very strong advocate and has taken a keen interest in supporting people with diabetes, while also championing preventive care. I was delighted he secured €500,000 in budget 2024 to fund the establishment of a new national diabetes register. This register is an important development in how we respond to and manage diabetes in Ireland. It will draw on quality real-life data to support the design and delivery of future services for diabetes. This will help to improve diabetes care for patients throughout the country and it is very welcome. I thank Ministers for their support.

I will turn to health service funding for a moment. It must be noted that healthcare funding is at record levels, with an increase of more than €5 billion since 2019. Just like any front-line demand-led service there will always be calls for increased funding, and it must keep up with inflation and demographic changes. This is understood. I know from experience that the local CHOs do their best in difficult circumstances in certain areas. It is critical that they are supported in the services they provide. However, as Dr. Theresa Reidy noted recently, we must also ensure the funds allocated are spent properly to ensure effective services are provided. For example, we have seen significant increases in clerical and management grades that were unapproved. While they may be necessary, it is critical that the CEO of the HSE and senior management exercise proper budgetary control, particularly with the additional challenges of inflation. The HSE recently came before the Committee Of Public Accounts and this scrutiny will continue. I thank the Minister, Deputy Donnelly, and the Ministers of State, Deputies Butler and Naughton, for their efforts to secure additional funding and additional services, including at community level, to provide front-line services. It is greatly appreciated and their work is noted.

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