Eoghan Kenny (Cork North-Central, Labour)

I wish to address the provision of incontinence products by the HSE. Although the Minister of State is not the line Minister, I wish to raise this serious issue for families across the country. Incontinence products are essential. They are used daily. I wish to speak specifically about incontinence products for children. I refer to a specific case raised by a parent with me in relation to her son. I will read out some of her correspondence to me, with her permission:

My son was born prematurely before 26 weeks in May 2021. In his first few weeks, he suffered a lung haemorrhage, two brain haemorrhages and a bowel rupture that led to a stoma for a year. He also experienced significant eye issues and has since been discoursed with cerebral palsy. Every step of the way has been a fight, and I have had to pay privately for nearly every service he is entitled to under the CDNT system. I have remained quiet until now, but the latest development has left me utterly shocked and disgusted. Now that my son is four, he qualifies for HSE-provided incontinence pads. However, he has yet to receive any. He currently weights 21 kg and still wear Pampers size 8 - the largest I can find - despite them no longer fitting properly. Pull-ups in size 9 are available, but they're unsuitable as he wears and AFO. The most infuriating part of this situation is that I have been told he will only be allocated four pads per day. He routinely goes through at least eight nappies a day - and that's while I'm still paying for them myself. To be told by a district nurse not to change him if he is only wet - with the implication that he must sit in it to conserve supplies - is not only medically unsound but dehumanising. After all he has been through, particularly with his bowel and stoma history, I will not stand by while his dignity, comfort, and skin integrity are compromised to meet a quote. Only last week, a doctor speaking on a documentary about nursing home care highlighted how unacceptable it is to leave people sitting in wet nappies. Why should it be any different for a four-year-old child with complex medical needs?

The Minister of State will appreciate the distress, anger and disappointment felt by this mother.

Her word "dehumanising" puts it lightly.

I tried to resolve this issue through a parliamentary question but the HSE response to me was quite unclear. It stated that, based on a clinical nursing assessment, a public health nurse may prescribe containment products to assist with the management of incontinence and that the provision of containment products is subject to parent-client engagement in a toileting programme. It added that the clinical nurse specialist for continence in north Lee is currently working with the child and his family. Furthermore, it stated the prescription of containment products is in line with the child's assessed requirements and that these will be monitored or adjusted as necessary by the clinical nurse specialist. I am sure that is probably in the response the Minister of State has.

Does the Minister of State know what the policy on incontinence product provision is? How many products may be allocated to children with complex needs? This mother has been told four is the limit; however, it has increased to six. The mother told a nurse she was lobbying local TDs. Will the Minister of State provide clarity on the number for me?

The nurse the parent is engaging with in her community has met her only once and has never met her child. That does not align with the clinical nursing assessment and the policy on the prescribing of incontinence products as outlined in the parliamentary question. In the response, the HSE highlighted engagement with a toileting programme. Of course, the mother wants her son to be toilet trained at some stage, but that will not happen overnight. I ask the Minister of State to engage on this specific case or ask his colleagues in government to do so to ensure the child will be provided with the number of incontinence pads required per day.

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