Wednesday, 6 February 2008
Déirdre de Búrca (Green Party)
I ask the Minister for Health and Children to outline her intentions on the implementation of the recommendations of the Pollock report. This report was commissioned by the Cystic Fibrosis Association of Ireland and was published on 7 February 2005. Its author is Dr. Ron Pollock and the title of the report is, An Independent Review of Cystic Fibrosis Services in Ireland. The report stated that at the time, 1,143 patients were under care in the State, with 45% being adults and 55% being children. It also pointed out that Ireland has the highest incidence of cystic fibrosis in the EU, with on average one in every 1,600 persons suffering from cystic fibrosis. A disturbing finding was that the outcomes for cystic fibrosis patients in Ireland are worse than in other EU member states. The report contended there was a higher number of cystic fibrosis-related deaths in Ireland than in England, Wales or Northern Ireland.
The report's recommendations provide an important blueprint for the future care of people with cystic fibrosis in this country. I ask for an immediate implementation of these recommendations. I raise this matter on the Adjournment of the House as a means of establishing the Minister's intentions in this matter. The main findings of the report were that staffing levels in cystic fibrosis services were seriously inadequate. The report refers to a striking absence of specialist registrars and an inadequate number of cystic fibrosis nurses, physiotherapists, dieticians and psychologists. The report also highlighted the lack of segregation and isolation facilities and it particularly highlighted those in the Dublin area which were felt to fall well below accepted standards. Unfortunately, the most well known hospital to provide cystic fibrosis services in the Dublin area, St. Vincent's Hospital, was mentioned in the report as being in particular need of investment and upgrading. It was stated that because of the lack of these segregation and isolation facilities for cystic fibrosis patients the risk of cross-infection was high with virulent organisms such as MRSA and hepatitis C.
The report also highlighted that as a small discipline, cystic fibrosis was particularly vulnerable to the vagaries of funding and was looking for more secure and stable funding into the future. The report recommended that urgent action was needed to address staffing problems in cystic fibrosis services; that a small number of highly staffed and fully supported cystic fibrosis centres should be created around the country with good geographical access for different parts of the country; that the links between the adult and children's units should be strengthened; that the adult provision outside Dublin should be developed urgently to create balanced services and to reduce the burden on St. Vincent's Hospital in Dublin; that all beds for cystic fibrosis patients should be in single rooms with en-suite toilet facilities to prevent transmission of dangerous organisms; that a microbiology reference library should be established in Dublin to champion advances in knowledge and treatment in the area of cystic fibrosis; that a new funding methodology, possibly based on banded packages of care should be developed to create the stability required in the funding system; and that the cystic fibrosis registry of Ireland should be maintained and developed.
They strike me as good and sound recommendations. Obviously they have funding implications and I am interested in hearing the Minister for Health and Children's intentions in regard to the implementation of some of these recommendations.