Dáil debates
Tuesday, 28 June 2016
Topical Issue Debate
Hospital Staff Recruitment
5:00 pm
Anne Rabbitte (Galway East, Fianna Fail)
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I do not need notes to talk about the deficiencies in paediatric diabetes services in County Galway because I have been harping on about this issue since I came into the House at the beginning of April. I am pleased that I will receive a reply from the Minister of State at the Department of Health, Deputy Marcella Corcoran Kennedy, today. Given that six months have passed since the launch of the new model of care for children with diabetes, I would like to know when the post at University College Hospital Galway will be filled. The need for the vacant paediatric diabetes specialist position at the hospital to be filled cannot be underestimated. Children in the region who are encountering serious delays in accessing specialist treatment have to go to Limerick or Dublin to avail of these services. The families agree with me that it is unacceptable that treatment is not being made available in Galway to children with a particular form of type 1 diabetes that requires them to use an insulin pump. It is disappointing that even though changes are being made under the new model of care launched last December, this service is still not available, six months on.
The Minister of State might not be aware that a contract has issued for a person to fill the vacancy I have mentioned. Believe it or not, the person in question will not take up the post until February or March next year. When I previously tabled a parliamentary question on this matter, in fairness to it, I received an answer from the hospital in Galway. I cannot understand why contracts are issued to people who are not in a position to take up the posts to which the contracts apply. Perhaps the Minister of State might explain the reason to me. Why do we issue contracts if we do not have the funding to pay for the posts? It seems that parents have waited for almost five years for this announcement to be made.
Four women attended my clinic in Loughrea recently about this matter. One woman, from Oranmore, has to attend Limerick University Hospital with her seven-year-old. Another, who came all the way from Headford to meet with me, travels two and a half hours to Limerick for the service. One woman is waiting, with bated breath, to get her ten-year-old into the service. Another woman from Claregalway who has a 14-year old daughter is travelling to Dublin for the service.
Their concern is that if they have an emergency, the files are not held in the Galway emergency department that they would have to attend. While they are only 40 minutes from the Galway hospital, their children’s files are not held on the campus. One woman told me that, in the case of an emergency, she would take the chance of travelling to Dublin. In this day and age, chances are not good enough.
I attended the diabetes conference in the AV room last week which was an outstanding event. However, I heard Limerick University Hospital is struggling, down to half a post. Now, the west and the mid-west are under serious pressure. Will the Minister of State explain what plan is in place to deal with this? These parents are not happy with the way things are. If I were a parent in such a position, I would not be happy either. I would think our health service is failing our youth.
With high blood sugar levels, hyperglycemia, or low blood sugar levels, hypoglycaemia, time is of the essence. However, accident and emergency services in Galway are under pressure. It is not acceptable that there is no consultant in Galway to look after children with diabetes, particularly in emergency cases.
5:10 pm
Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Deputy Anne Rabbitte for raising this issue. From her contribution, one can hear how informed she is about it and how passionate she is in assisting the parents who have approached her about it.
Children’s needs should be at the centre of what we do and how we look after them. Parents and families face many challenges in caring for their children with diabetes. I acknowledge that this is not easy.
Galway University Hospital serves as a regional centre for the delivery of diabetes, endocrine and related services to the population of the west. A consultant paediatrician with a special interest in diabetes has been recognised as a priority post for the hospital. A consultant has been appointed. However, the successful candidate is overseas and, owing to prior work commitments, is expected to take up post in March 2017. While every effort is made to offer the patients an appointment at the hospital as close as possible to where they live, there are instances where local hospitals do not have the necessary capacity. In this instance, patients are offered care at an alternate hospital in either the public or independent sector.
There is an arrangement in place with Limerick University Hospital whereby all infants and children with newly diagnosed diabetes under five years of age are referred for specialist services. This will continue until the new postholder starts work. The Saolta hospital group advises that it is seeking to recruit a locum consultant in the intervening period. Also, in the Saolta hospital group region, an insulin pump therapy service for children in the north west is in place at Sligo University Hospital, with outreach clinics being delivered at Letterkenny University Hospital.
At a national level, a new model of care for paediatric diabetes was launched by the then Minister for Health, Deputy Varadkar, last December. This model of care was developed with expert input in line with international evidence. The consultation process also involved diabetic representative organisations, children with diabetes and their parents. The model proposes to organise paediatric diabetic care around integrated practice units, which will consist of one centre of reference while several additional units will undertake all forms of diabetes care. Tertiary care and insulin pump therapy will be provided to children of all ages by a multidisciplinary team. Additional units attached to the centre will support the delivery of services locally acting under the umbrella of these integrated practice units.
Full implementation of the model of care by the HSE will take place over the coming years. This model of care will improve access to and the quality of care for affected children by reducing acute and chronic complications associated with type I diabetes. It will also improve the quality of life for children and families by optimising diabetes education, carbohydrate counting and insulin pump initiation.
The Department of Health will continue to work with the HSE to ensure the service needs and waiting times in this area will be addressed.
Anne Rabbitte (Galway East, Fianna Fail)
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While I accept the Minister of State’s reply, regrettably the frustration for the parents and the families in question is that the post, which was advertised, has not been filled. Whatever way we look at it, it looks like it will not be filled until March 2017. When I said I would raise the issue on behalf of the parents, their only ask of me was if there was any way the post could be filled in 2016. It is my second time asking the question but I am getting the same answer, essentially March 2017.
Will Limerick University Hospital be able to deal with the extra capacity? Listening to what was said last week in the AV room, it would seem the post at that hospital is under pressure. My concern for the family travelling there from Galway is that this is a service available every second week. I appreciate there is a service in Sligo University Hospital and the people in the north west are quite happy with it. However, the people in the west feel isolated and rejected.
It is also important for me to acknowledge the hard work done by the specialist nurse in Galway University Hospital. By all accounts, she seems to be keeping the whole show on the road but she needs a little more support.
I am glad the Minister of State acknowledged what it does to the families in question, namely, a day off work and a day out of school. While we acknowledge all they are doing, it is little comfort to them that nothing will happen before March 2017. Will Limerick University Hospital be able to cater for the needs of those patients from Galway? Is there any way that, if there were a chronic emergency with one of these patients, through IT systems they could be treated at Galway University Hospital?
Marcella Corcoran Kennedy (Offaly, Fine Gael)
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Every effort is being made to appoint a locum in Galway in the intervening period until the person who has accepted the post can take it up in March 2017. That is the good news.
The question was specifically on Galway, so I do not have a specific response about the issues the Deputy raised about Limerick’s capacity. I will certainly find out for her. As soon as I have it, I will forward it to her. We do not want people having concerns about the availability of the service required by the children in question.