Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this very important issue. Historically, Ireland has a very high prevalence of COPD. There can be different factors involved, even climate. The Deputy outlined towards the end of his contribution the public health framework which governs much of this. Smoking was a big factor but also tended to be a socio-economic issue with regard to its prevalence and scale. As a country, we have taken various measures on smoking which have helped but there are issues around work safety in terms of dust and inhalation. We have improved a much of that compared to where we were ten or 20 years ago so that prevention piece is extremely important. The Deputy is correct to refer to housing also and the quality of it. Those are all areas which will help to prevent COPD.

In addition to that one needs a proper community-based model of care and an acute system of care. In 2019, the HSE developed a COPD model of care which redefined how health services are to be provided to people with the disease. In November 2021, the first national clinical guidelines for the management of COPD were launched. That idea was to have the right care delivered to people with COPD at the right time and in the right place. The chronic disease management programme commenced in 2020 and has been rolled out to all adult general medical services, GMS, patients over a four-year period. That chronic disease management programme is an entirely new healthcare service in Ireland and has brought the care for chronic disease further into the community. Its aim is to reduce hospital attendance by patients with one or more of these specified conditions. COPD is a specified chronic disease which falls to be managed under that particular programme.

Through the chronic diseases management contract, as Deputy Naughten has said, GPs are funded to provide structured reviews and interventions in time with the model of care. Each patient receives two scheduled reviews with a GP in a 12-month period, each preceded by a practice nurse visit. Those reviews are to include patient education, preventive care, medication review, physical examinations, individual care planning and scheduled investigations.

In addition to the GP chronic disease management programme, the enhanced community care programme, as the Deputy knows, is a suite of strategic reform initiatives. Under that programme some 3,500 people are being recruited, with 2,800 already recruited. Some 96 community healthcare networks are now operational under the enhanced community care programme, 24 of the 30 community specialist teams, CSTs, for older persons are operational, and 24 of the 30 CSTs for chronic disease management are operational. Progress has been made but I do not doubt that more needs to happen because COPD is a particularly nasty disease which can significantly hamper a person's quality of life. We will continue to work on it.

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