Martin Kenny (Sligo-Leitrim, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

This is the fifth or sixth time I have raised this issue regarding people with type 1 diabetes in the north west. Some 31 patients would benefit from having an automatic insulin pump fitted. The problem is that they cannot get the pumps fitted although they are on the shelf waiting for them because a diabetic nurse or specialist nursing staff are unavailable to train them in how to use them. The situation has been going on for six months. I have raised the issue on numerous occasions. I have spoken to the manager of the hospital and I have written to the hospital. I have written to the CEO of the hospital group. I raised the matter three times with the senior Minister, Deputy Harris. In fairness to him, he has always been very accommodating and he has told me that he would get back to me. I raised the matter with him again no later than last Tuesday week. I met him afterwards and he said he would get back to me before the end of the day. I know he is depending on people in the HSE to get back to him with answers, but nobody seems to have the answers.

In addition, Suzanne Donnelly, chairperson of the Sligo branch of Diabetes Ireland, wrote to the Minister's private secretary a few weeks ago about the 31 patients in the north west. The reply she received was outrageous. It said that under the 2004 HSE Act the Minister could not intervene on behalf of an individual patient. Her letter was not about an individual patient; her letter was about a service which was denied to people in the north west, and it is being continually denied.

I do not know who in the HSE is so incompetent or what idiot is not doing his or her job, but the only time the Minister, the Department and the HSE will gain any credibility with the public is when such people are sacked and lose their job and they will have to go to the Labour Court to explain why they are so god damn incompetent that they think that their job is to block people from getting a service.

I rarely get angry but it makes me very angry when the genuine people who have come to me, who need to get the service and are waiting for it, are being fobbed off and told the hospital has applied to get a nurse to provide the service. The nurse who was providing the service in the hospital in Sligo was seconded to another part of the hospital. She was not sacked and she did not go on maternity leave. Now the hospital says it has to apply to the HSE to get someone to replace her. The hospital says it is waiting for approval for the post. The post exists and those people are waiting. It is shameful that the situation has continued for so long. I do not blame the Minister directly but I do blame him for not dealing with it. Some individual somewhere is failing the people with type 1 diabetes in the north west who need an insulin pump. He or she will not take responsibility and hides behind bits of paper saying do not write to me about it again.

The Minister of State, Deputy Catherine Byrne, is here to respond. She has been given a response to read. To be honest, I do not expect it to be much better than the one Suzanne Donnelly got. It would be great if it is, but we are in trouble until we get to grips with the people in the HSE who think their job is to block progress and prevent people from getting their entitlements. The only way we will deal with them is to kick them out, give them their P45 and let them take a case to the Labour Court or wherever they want, but that is the only way the Minister can be seen to stand up for the patients who need somebody to stand up for them. I know the Minister, Deputy Harris, is genuine about this but along with the Minister of State, Deputy Catherine Byrne, and others who are also genuine, they need to stand up to the people who are blocking others in society who deserve to get a service.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Deputy Martin Kenny for raising this matter. I am aware that he has raised it previously with me on a number of occasions. I understand that a reply has issued to the Deputy from the Minister, Deputy Harris.

Just like the rest of the world, Ireland is experiencing sustained increases in the number of people with diabetes. Currently, there are more than 200,000 people with diabetes in Ireland. People with type 1 diabetes make up 10% of all people with diabetes. Appropriate and timely management of diabetes can reduce the risk of deterioration in health and well-being.

The adult diabetes service in Sligo University Hospital is currently led by a consultant endocrinologist-general physician with her team, including one locum consultant. This service covers a catchment area including Sligo and Leitrim, south Donegal, north Roscommon and west Cavan. The adult diabetes service also includes an insulin pump service.

In addition, there is a pregnancy diabetes service, an inpatient ward-based consultation service, as well as an inpatient and outpatient podiatry service. There is a well-established, integrated multidisciplinary team approach between both the hospital and the community. On a hospital basis, the service is supported by specialist diabetic nurses in the hospital, specialist diabetic nurses in the community, an advanced nurse practitioner working between the hospital and the community and a full range of support staff, both across the acute and community services. There is a well-established shared care approach between the acute and community services including the specialist diabetic nurses and GP practices.

The adult service is complemented by a paediatric diabetes specialist service, which provides a regional insulin pump service for children across the north-west region. Both the adult and paediatric pump service has experienced considerable growth in referrals both from new patients commencing treatment as well as the relocation of patients from national centres.

A general paediatric consultant post was advertised in recent months which will provide for oversight of the insulin pump service in the north west. Interviews are due to be held in early July, following the completion of a shortlisting process in May 2019. That will ensure all new paediatric patients will commence their pump therapy at Sligo University Hospital for patients from Sligo and Donegal.

The development of the diabetes day unit at Sligo University Hospital is proceeding to stage 3 with the tender process now under way following the receipt of a letter of approval in April 2019. It is expected that building works will commence in quarter 3 of 2019, subject to funding approval for construction. The funding of all projects is subject to the availability of capital funding and the progress of other priorities.

The Government is committed to the further development of services for people with diabetes and other chronic conditions. Earlier this year, the Sláintecare Action Plan 2019 was published, which will be a fundamental enabler in the delivery of the Sláintecare vision. Under Sláintecare, integrated care programmes for people living with chronic conditions will also be implemented, as well as plans to expand capacity in GP and community nursing to manage chronic disease.

As part of the action plan, a total of four workshops were held, including one on diabetes. The workshops were attended by a mix of clinical and management stakeholders from the HSE and the Department and will inform future decision-making and service planning.

The Minister, Deputy Harris, is keen to continue to work with Deputy Martin Kenny and he has written to him today. I do not know whether the Deputy has received the letter.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

No.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have taken notes of the other points raised by the Deputy and I will respond on them after his contribution.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State. Much as I expected, the statement does not go to the heart of it because it refers to an advertisement for a general paediatric consultant's post. I refer to a service for adults, not children. Some 31 adults are waiting to be provided with the service. The paediatric service is available for children who require an insulin pump and they are getting it. The problem arises when they reach 18 years. One such patient is a young woman from south Leitrim who is going to college in Galway. She needs to get an insulin pump and she has been waiting four or five months for it. She cannot get it because there is no one to train her on how to use it. That is unacceptable in this day and age. It is the same for many others. A total of 31 patients in the north west are affected by the delay.

The statement also referred to the new diabetes care unit in Sligo University Hospital, which is proceeding to stage 3 of the tender process, but that is dependent on funding and we still do not have clarity on funding.

It would be useful to know that the funding is to become available. I do not want to stop focusing on the issue I am raising, however. The specific issue I am raising concerns 31 adults who need to get the insulin pump. It has been purchased for them and it is sitting on the shelf to be given to them but they cannot use it because there is no diabetes support and no specialist nurse to train them in its use. These are generally intelligent people who, with a small amount of training and assistance, would be able to make a great leap forward in the treatment of their type 1 diabetes if they could get the pump fitted. It has been denied to them in their area although it is available in other parts of the country. Therefore, the Minister of State can understand the people's frustration.

If the Minister, Deputy Simon Harris, has written to me today, I have not seen the letter yet. I will read it with interest. Let me return to the central point, which is that somebody somewhere is not doing his or her job. That person needs to be held to account. If the Minister will not do so, then we have to hold the Minister to account and say he is not doing his job. Somewhere along the line, the buck stops. The Minister must be prepared to find the individual, sort him or her out and determine what the hell he or she believes his or her job is. The individual is so incompetent that he or she can think that 31 people, for the sake of a little training, can be left to the wind and that letters can be written saying correspondence should be sent to the complaints department. That is what the HSE told the association in Sligo. It is absolutely ridiculous. It is time somebody's head rolled somewhere in the HSE for this kind of incompetence.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I note the Deputy's frustration and concern. I believe I have dealt with this Topical Issue matter twice before. I do not know what is in the letter sent to the Deputy by the Minister today. I do not know whether he will be pleased with it when it reaches his desk. It is a matter he will have to pursue with the Minister. I understand, although not from the reply I read, that there are 31 adults waiting for the pump to be given to them. I will pass this on to the Minister.

Regarding the frustration and concern of the Deputy and his remarks on HSE staff, I do not have any briefing but I will certainly pass on his remarks to the Minister. I believe I have covered most of the points the Deputy made. I will make sure, when I go back to my office, to inform the Minister about the Deputy's frustration and concerns, as I have done before. I hope that, when the Deputy reads the letter today, there will be some good news in it.