Seán Power (Kildare South, Fianna Fail)

I thank Senator Glynn for arranging this debate and thank the other Senators for their very constructive and extremely helpful contributions. Diabetes is a very serious issue and one would like to think this debate will generate debate outside the House. The more exposure the subject gets, the better.

Senator Henry made a number of points and one would always have to respect her opinion on matters medical. She stressed the need for greater emphasis on haemochromatosis in the diabetes strategy. She and others referred to obesity and the need for increased physical activity. Physical activity can involve a practice as simple as walking. Unfortunately, for a variety of reasons, people are not walking nearly as much as they used to. We will have to change this situation.

Senator Glynn mentioned the expert advisory group. Its existence is an indication of the seriousness with which we are treating diabetes. He also mentioned the need for an extra endocrinologist in the Mullingar area. We appreciate the benefits this would afford and we will certainly consider it.

Senator Browne mentioned the necessity to increase the number of podiatrists and the issue of food labelling. He also mentioned the need for an information campaign on this matter. He referred to the experience of a friend who discovered he was a diabetic but who was very appreciative of the type of service available to him. It is heartening to know this type of service is available.

Senator Browne asked whether we are putting out the fire or preventing it. Unfortunately both approaches are required. Diabetics cannot be ignored and we do not want to ignore them, and it is therefore important to provide them with the service they need while encouraging others to take steps to prevent themselves from needing it. Their current lifestyle will determine how healthy they will be in later life.

Senator Kate Walsh, a diabetic, gave us some idea of the difficulties diabetics experience and also stressed the importance and value of early diagnosis. We all agree with her in this respect.

Senator O'Meara asked about costs. While I do not have the relevant figures to hand, I acknowledge that her question is important. Unfortunately when considering the provision of service, the cost always comes into the equation somewhere along the line. It can often determine the type or level of service provided. We should forget about the cost for a moment and consider the effect on the life of a person who develops diabetes, which is impossible to quantify. The Senator asked the question and we will try to get some more information. In 2003 it was estimated that we had 900 inpatient discharges for diabetics, for which the cost worked out at approximately €3.5 million, which represents a cost of slightly more than €4,500 per patient. I will try to get more specific and accurate figures. The Senator also mentioned the need to expand health promotion.

Senator Maurice Hayes spoke about his wife who banned fizzy drinks in the classroom and the obvious benefit in a short period. A number of schools have been very proactive in dealing with the matter. They have encouraged children with initiatives such as having a particular day when only healthy foods are allowed. Many parents have learnt from their children rather than the reverse. They are much more educated and aware than pupils would have been in previous years.

I thank the Members for their contributions. Diabetes is a lifelong condition that impacts on almost every aspect of life. It can affect all ages and cases have been diagnosed in babies as young as 12 months. Type 2 diabetes accounts for 90% of all cases and it is widely acknowledged that the increase in this disease can be attributed to our aging population and the rise in the incidence of obesity. The effect of the disease on the individual has been well documented. However, the impact on the health service is also substantial with, for example, an increase of 32% in hospital admissions in the past three years.

GPs and primary care services have an essential role in diagnosing and treating patients with diabetes. Early interventions can minimise many of the effects of the disease. An integrated service involving hospital and primary care will ensure the best outcome for patients and this in addition to other recommendations has been documented in the strategy produced by the Department of Health and Children. The response of the HSE to the strategy has been swift with the imminent establishment of an expert advisory group.

The HSE has identified priorities, including the development of a mechanism for the identification of high-risk patients and the expansion of the screening programme for diabetic retinopathy. Funding has been secured to develop a self-care and management network for patients with diabetes in each of the four administrative areas for the development of multidisciplinary community intervention teams for diabetes.

On the question of personal health, many things happen to people who become ill. This is one area in which people have certain control and their lifestyle choices will influence their health. We must encourage people to balance their lives in every respect and particularly in diet and physical activity. Both Government and local authorities must make it an easy option for people. With the long evenings it is much easier for people to take exercise. However, to cater for the winter nights, we need to ensure that we build housing estates with walkways that are well lit so that people can feel secure when taking exercise. Facilities such as walkways and playing pitches must be made more plentiful and accessible. It is our duty to encourage people to live healthier lifestyles, which is what we are trying to do. While we have had some success, it is important that we build on it.

The HSE has prioritised diabetes and the effects of this will become apparent as services become integrated and more accessible. I am optimistic that the rise in the incidence of diabetes can be halted and reversed and that the effects can be minimised and maintained at levels that enable people to go about their everyday lives.