Timmy Dooley (Clare, Fianna Fail)
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I welcome the Minister of State to the House. I seek the assistance of the Minister on behalf of patients in the mid-west region in freeing up what appears to be a logjam in the roll-out of services for patients with cystic fibrosis, CF, in particular at Limerick Regional Hospital.

The Minister will be aware that the recommendations of the national working group on CF services were accepted. I understand €559,000 was set aside to upgrade services for CF patients. The Minister may be aware that 77 children and 46 adults are currently being treated at the Limerick Regional Hospital. Funding for CF services was allocated by the Health Service Executive following the Pollock report on CF services in 2006. Nationally, €4.8 million was provided, of which €2,072 million has been set aside.

As I stated, €559,000 was allocated directly to Limerick Regional Hospital to fund a number of positions. Two of the urgently required positions have not yet been filled, namely, an adult respiratory consultant with an interest in CF and a paediatric respiratory consultant with an interest in CF. The concern of patients in the region is to identify where that funding is and why these services have not been rolled out. The funding, as I understand it, was to support the cost of an additional eight staff, identified for the adult and paediatric CF services at the Dooradoyle facility. Included in the eight additional staff were two consultant posts, a consultant physician for adult services with a special interest in cystic fibrosis and a consultant paediatrician with a special interest in cystic fibrosis. That is the minimum required to provide the type of services needed for patients in the region.

There has been a considerable outcry during the past couple of years in regard to the treatment of individuals with cystic fibrosis and there was some movement by Government in this regard, in particular in regard to services to be delivered at St. Vincent's Hospital on the east coast. It is only right and fitting — I know the Government and Minister is committed to this — that the type of facilities available on the east coast are made available to people from the mid-west region who have cystic fibrosis. While the money for this has been set aside, services have not to date been rolled out. It is incumbent on the Minister and her Department to use their good offices, taking into account the assistance from the HSE, to move this forward without any further procrastination or delay.

While a relatively good service is provided in the paediatric area, there is need for an extra consultant. There is little service available to adults suffering from CF, which is a progressive illness. Clearly, there is a requirement to ensure continuity of service in respect of children moving from the paediatric service to the adult service. I understand also that a physiotherapist is required in the adult section. Anybody who understands CF knows that physio is the cornerstone of therapy to be delivered to patients suffering from that condition. It is absolutely necessary that these services are rolled out without delay, that the positions are advertised and that appointments are made as quickly as possible so that the same degree of service as is available on the east coast can be delivered in the mid-west region.

Mary Wallace (Meath East, Fianna Fail)
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I thank Deputy Dooley for raising this important issue.

The Cystic Fibrosis Association of Ireland commissioned Dr. Ronnie Pollock to review existing hospital services for cystic fibrosis in the context of accepted international standards. The report, which was published in 2005, provided an assessment of need for current and future cystic fibrosis patients. Following publication of the Pollock report, the Health Service Executive established a working group to undertake a detailed review of cystic fibrosis services. The remit of the group, which was multi-disciplinary in its composition, was to review the configuration and delivery of services to persons with cystic fibrosis in Ireland.

In recognition of the need to improve services for these patients, the Minister for Health and Children identified the development of cystic fibrosis services as a policy priority. As Deputy Dooley stated, additional funding of €6.78 million was provided to the Health Service Executive in 2006 and 2007 to develop these services. The HSE has advised that 44 additional staff dealing with cystic fibrosis have been appointed to date across a number of hospitals, including Limerick Regional Hospital and eight other hospitals. The necessary funding is available to facilitate the recruitment of a further 37 staff nationally, including staff for the mid-west region. The services in place for cystic fibrosis patients in the mid-west region were built up over a number of years, as acknowledged in the Pollock report.

The current adult cystic fibrosis service for the mid-western region is provided at the Mid-Western Regional Hospital Limerick by two consultant respiratory physicians providing inpatient and outpatient services. The cystic fibrosis service for children is provided by a consultant paediatrician and involves both inpatient and outpatient services. Two nurse specialists currently cover both the paediatric and adult cystic fibrosis services. Adult and paediatric cystic fibrosis services are also supported by a dedicated team, which includes a social worker, a dietician, a physiotherapist and a pharmacist.

The Mid-Western Regional Hospital, Limerick, provides three dedicated rooms for adult cystic fibrosis patients. These rooms may be used for other patients if not required for cystic fibrosis patients. Paediatric cystic fibrosis patients are accommodated in the paediatric unit.

With regard to additional clinical posts mentioned by Deputy Dooley, eight and a half additional clinical posts have been approved to enhance the adult and paediatric cystic fibrosis service in the mid-west. Four of these posts are now in place and recruitment arrangements for the remainder are in train. This includes the two additional consultant appointments the Deputy referred to, which are proceeding through the recruitment stages. Subject to a satisfactory outcome to the recruitment process, the remaining appointees for the mid-west are expected to take up posts in 2009.

I thank the Deputy for raising this important matter. The Minister is confident that these developments will significantly enhance the level of service provided for persons with cystic fibrosis in the HSE mid-western area.