James Reilly (Dublin North, Fine Gael)
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Question 37: To ask the Minister for Health and Children if she will roll out the national retinopathy screening programme in view of the fact that retinopathy screening for people with diabetes is highly cost effective in terms of the long-term health gain and money saved through prevention and in view of the recent publication of the Health Service Executive report recommending the programme; if not, the reason for same; and if she will make a statement on the matter. [13412/09]

Mary Wallace (Meath East, Fianna Fail)
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As the Deputy is aware, this issue was the subject of a full debate in the House on 26 February 2009. As I indicated then, the HSE plans to roll out a diabetic retinopathy screening programme on a phased basis by HSE area. It is proposed to commence in the HSE west region, as a population-based screening programme had previously been established in the former North-Western Health Board. Funding of €750,000 is being allocated to implement this first phase of the screening service. This will allow the service to be offered to approximately 30,000 people with diabetes, registered with the programme, between west Limerick and north Donegal. It is estimated that this programme will commence in the third quarter of 2009. Once the first phase has been established, the programme will be rolled out on a phased basis, having regard to overall resource availability and other competing priorities.

James Reilly (Dublin North, Fine Gael)
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For the record, we did not have a debate on this issue. We had statements on it which is quite a different matter. Will the Minister bear in mind that approximately 5% to 10% of people with diabetes have sight-threatening retinopathy? This requires treatment and if they do not receive it, some 14,000 to 16,000 will end up with sight-threatening retinopathy by the end of next year. The cost of providing a comprehensive retinopathy programme is approximately €1.9 million with ongoing costs of €2.5 million per year. The cost to the State of the care of 100 people who are sight impaired runs to €2.4 million. For the price of looking after 100 blind people, we can prevent thousands of cases of blindness. If there was ever a case of penny wise pound foolish, this is it.

I recounted the story at the Oireachtas Joint Committee on Health and Children, and I will repeat it here, of a gentleman who went blind waiting for an outpatient's appointment. He went to England and had partial sight restored to his left eye. He has returned here and on at least three occasions prior to a six month appointment he was told it had been put back for another six months. This man is extremely angry for his own sake and for the sake of the many other people he knows who suffer the same consequences. It is a small amount of money for what is a form of prevention. Tough decisions will always have to be made, but we must invest in prevention to save money tomorrow. For every euro we spend on prevention, between €12 and €20 will be saved on treatment, and this €1.9 million needs to be made available.

Mary Wallace (Meath East, Fianna Fail)
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Funding of €750,000 is available in 2009 for the purpose, but the estimated total cost of the scheme nationally will be €4 million. The key message is that despite the difficult financial situation, this is being rolled out in the HSE western region. We picked that area because a population based screening programme was located there previously. We are putting in place all of the various pieces we need to put in place for 2009, including governance and committee structures and the processes involved. There also has been recruitment of staff for the IT side of the scheme. It is a good news story as it is getting priority under the current financial situation and the roll out is happening on a phased basis.

James Reilly (Dublin North, Fine Gael)
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The Minister of State is well aware that this money was available in 2008 and 2007, when we were not in such straitened times, yet it was not spent. While we welcome the fact that it is being rolled out in the west, what about the rest of the country? What about the rest of those with diabetes who may lose their eyesight due to a failure to detect their retinopathy, which is an eminently treatable condition?

Mary Wallace (Meath East, Fianna Fail)
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There is no doubt we are facing resource constraints and that is why it was not rolled out in 2008. We can certainly say this is a positive development as it is happening in 2009 in the west, where 30,000 people will be screened. Thereafter, depending on the availability of overall resources, this will be the first phase of the national roll out.

James Reilly (Dublin North, Fine Gael)
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So there will be no relief for the remaining 110,000 people with diabetes.