Kathleen Lynch (Cork North Central, Labour)
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I wish to clarify that Deputy Ciarán Lynch will not be in this slot. It will be Deputy Allen and myself, so we will have five minutes each.

John O'Donoghue (Kerry South, Ceann Comhairle)
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The time is divided by two instead of by three.

Kathleen Lynch (Cork North Central, Labour)
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No wonder the Ceann Comhairle got the good job. He is much better at it than I am.

I wished to ask the Minister for Health and Children if she is aware that the number of children attending for care at the paediatric diabetes unit at Cork University Hospital has risen to 270, which is more than twice as many as were attending four years ago; if she will outline the extra resources that have been given to the unit to cope with this extra demand; if she will explain why the clinical nurse specialist who was to take up her post on 23 September has not been appointed; and if she will make a statement on the matter.

It is not normal for a Deputy to read out his or her entire request for the Adjournment debate, but it is important, for many reasons, that this one be read out. It is virtually the same Adjournment request that was made on 7 March 2006. Since then the numbers being diagnosed with childhood diabetes at CUH have risen from 207 to 270. We should bear in mind that we are talking about children as young as 18 months. They are sometimes younger, but 18 months is near the average. In one instance a mother told me that she was in shock at having discovered that her child had diabetes and that she was given a syringe and an orange and told to practice on that and she would be fine, and to go home and treat her child.

All that is available to the parents in Cork is the help they can give to one another. They do not have a 24-hour service, as exists in Dublin, where if a child's blood sugar seems to be fluctuating a parent can pick up the telephone to the nurse specialist. They do not have a full-time paediatrician. As and from today, even though it has not been confirmed, there is the possibility that a dietitian with specific interest in children and childhood diabetes may have been appointed, but this is not fully confirmed. There is have one nurse when there should be three, and that one nursing post is filled by two half-time nurses. This time last year an additional nurse was promised, but that appointment was not made. There is no oncologist. There is a specialist who also works with other specialties.

Where do we go from here? There were parents outside CUH this morning and they did not want to be there. These mothers and fathers have other things to do. They have sick children to look after but they know that if they do not take a stand, the quality of their children's lives will be immeasurably worse.

The outcome for children with diabetes is good if they get the proper care and attention. If one lives in Dublin, one gets the proper care and attention. In fairness, the staff in Temple Street hospital have taken in children from Cork. Parents are willing to travel every three months to have their children get the proper treatment, but why should children in the south, from where the Ceann Comhairle comes, have less of a chance of proper health care than those in Dublin? Clearly, we are not treating all the children of this nation equally.

I may get the same answer tonight as I got on 7 March 2006, the end of which stated:

Hospital management has reported that the suggestions made at this meeting [between hospital management and the parents] are currently being examined. The development of the paediatric diabetes service remains a priority for the executive management board of Cork University Hospital. The Tánaiste is confident that the Health Service Executive will continue to monitor the delivery of this service to ensure that the needs of the service users are prioritised and met.

When will we see that and what about the health of these children?

Bernard Allen (Cork North Central, Fine Gael)
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I thank the Ceann Comhairle for the opportunity to raise this issue again tonight. With other Deputies, I raised it in 2006 and we are forced to raise it again tonight. Effectively, Professor Brendan Drumm, who is the chief of the Health Service Executive, has given the two fingers to the Oireachtas Members of Cork North-Central and Cork South-Central. We all signed a letter, which was one of the few signed by all Deputies in both constituencies, in March last. We requested a meeting with him to discuss this serious issue and we have not even got a reply. That is accountability in the style of the Health Service Executive, which will go through another one in a series of charades of meeting public representatives — I intend no insult to the Ceann Comhairle who will chair a meeting next week — preaching to us and not giving us an opportunity to interact or to communicate properly. We sent a request, signed by all Oireachtas Members concerned, for a meeting but we received no response. That is why we must raise the issue here.

No doubt I will be told tonight this is a matter for the Health Service Executive. Accountability has gone out the window. We do not know what is happening within senior management of the Health Service Executive. They are all promoting themselves. There are many managers but there is no management of the health services and we will not stand for that because the people of Cork deserve better.

The parents of chronically sick children were forced to take to the footpaths of Cork University Hospital again this morning because of the situation, as outlined by Deputy Kathleen Lynch. I will not repeat much of the detail the Deputy has given.

I hope the Minister of State, Deputy Hoctor, will not tolerate the attitude and the behaviour of Professor Drumm and his management team who seem to think that public representatives are just a crowd of nuisance makers. The Ceann Comhairle and I served on a health board for a number of years and we saw that on every item on the agenda, and even items that were not on the agenda, we could challenge and question management on the burning issues of the day. Now one cannot even get a response. A parliamentary question I tabled to the Minister for Health and Children, Deputy Harney, on 2 October was referred to the Health Service Executive and I have yet to get a reply on that urgent and important issue.

In November 2006 there was need for a consultant paediatric endocrinologist, who has still not been appointed. There was need for a consultant paediatrician — there is a part-time one in place at present. There were supposed to be three clinical nurse specialist to help the 270 children, to whom Deputy Kathleen Lynch referred, but there is the equivalent of 1.1. There is no dietitian, there is a half-time social worker and there is no dedicated clinical space.

This matter has been rolling on for many years with no accountability and no real response. This issue is not being taken seriously. Cork and the southern area is out of touch totally with what is happening in the rest of the country in the treatment of child diabetes. This should not continue.

I ask the Minister of State, Deputy Hoctor, who is representing the Minister for Health and Children, to carry out a departmental investigation into the mismanagement of this entire affair by Professor Drumm who, as I stated, is giving the two fingers to Oireachtas Members by not even responding to a request for a meeting where we could discuss with him and his many highly paid managers this ongoing burning issue. He should be brought to task for non-performance, despite his large bonus, and his contempt, not for public representatives but for the parents and sick children of the greater Cork area.

John O'Donoghue (Kerry South, Ceann Comhairle)
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I know Deputy Allen does not mean any discourtesy, but we cannot refer in a disparaging way to people who are not Members of the House because they do not have the opportunity of defending themselves in the House. That is a long-standing rule of the House.

Bernard Allen (Cork North Central, Fine Gael)
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I know but if he does not have respect for Oireachtas Members, I do not think——

John O'Donoghue (Kerry South, Ceann Comhairle)
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I have to remind the Deputy of that.

Bernard Allen (Cork North Central, Fine Gael)
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I accept the Ceann Comhairle's ruling.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank Deputy Kathleen Lynch, Deputy Allen and, indeed, Deputy Ciarán Lynch for raising this issue today.

The Minister is aware that the number of children diagnosed with insulin dependent diabetes who are attending Cork University Hospital, CUH, has increased from 122 in 2000 to 275 in 2007. She is pleased to note that the HSE is taking steps to boost the service for these children.

The HSE has succeeded in recruiting a senior dietician for the paediatric service and a suitably qualified dietician commenced providing the service from Tuesday, 30 October. The funding and whole-time equivalent for the post has been ring-fenced and the post will be established in the hospital in a permanent capacity. A clinical nurse specialist post has been offered to a nurse who is already working in the paediatric unit at the hospital. She will be able to take up duty when her current post has been back-filled. It is likely that approval for her replacement will be granted shortly.

The CUH provides a service whereby a dietician and the clinical nurse specialist for diabetes attend the general paediatric clinics to see urgent cases of children with diabetes, for example, those who are newly diagnosed, have a new regime or are experiencing difficulties with control. The hospital management has given an assurance that every effort will be made to ensure that all the relevant staff attend these clinics.

The HSE has under consideration the following additional staffing level requirements for the paediatric diabetic service in the south for 2008: 1.2 whole-time equivalent, WTE, clinical nurse specialists; 0.20 WTE dietetic support; 0.5 WTE consultant paediatrician — a share of 1.0 WTE who has a special interest in diabetes and endocrinology and has a general paediatric commitment; and 0.3 WTE social worker support, who also shares the general paediatric commitment.

Kathleen Lynch (Cork North Central, Labour)
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That is exactly what they have.

Máire Hoctor (Tipperary North, Fianna Fail)
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These posts would form part of a multidisciplinary team with the nursing and dietician posts currently being put in place. The general manager and nurse service manager of Cork University Hospital, together with the business manager for the division of paediatrics, have met with representatives of the support group and are fully aware of their concerns in regard to the paediatric diabetic service. The Minister is satisfied that every effort is being made to address those concerns.

At the end of 2006, the Health Service Executive established an expert advisory group, EAG, on diabetes to draw up standards of care for persons with diabetes. This process will take account of the Department of Health and Children document, Diabetes: Prevention and Model for Patient Care. The EAG has subdivided its work into six areas: standards of care, retinopathy, paediatrics, education and patient empowerment, podiatry and model of shared care. The EAG will report in 2008 and the allocation of any additional resources for diabetes will be informed by this process.

The Minister is confident that the measures being adopted by the Health Service Executive will bring about much improvement in the paediatric diabetic services in the Health Service Executive southern area.

Kathleen Lynch (Cork North Central, Labour)
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That is exactly what is there at present. There is nothing new in the reply.

John O'Donoghue (Kerry South, Ceann Comhairle)
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We cannot go into the matter now.

Kathleen Lynch (Cork North Central, Labour)
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I am sorry about that.