Frances Fitzgerald (Fine Gael)

I congratulate the Minister of State on her appointment and wish her success. I note, however, that in the appointment of Ministers of State, she is the only woman and we have lost two female Ministers of State. I regret the number of women in the Government has taken a backward rather than a forward step, given our very low representation in the Houses generally. That is a backward step, but I wish the Minister of State success.

The key point in the Minister of State's speech was contained in its closing paragraphs, namely, that "Owing to resource constraints, the diabetic retinopathy screening programme did not commence in 2008". Another key sentence in her speech was that, "Currently all recruitment actviity and recruitment competitions are placed on immediate hold pending further clarification regarding the filling of posts." Therefore, as the Minister of State said, there is a great uncertainty about the future of this vital service.

The statistics on the incidence of diabetes in Ireland are frightening, as I am sure the Minister of State will agree. Diabetes is no longer a future threat to the health of our people, rather it is a current crisis. An estimated 250,000 people have diabetes. It is estimated that approximately 100,000 people do not yet know that they have the condition. The Minister of State might comment on this figure or report back to the House on it. A significant number of people who have the condition are undiagnosed, they do not present for treatment because they are not aware they have the condition and, therefore, they are not able to take the kind of preventative action that is necessary.

It is also expected that the number of people suffering from diabetes in Ireland will double in the next decade. This is undoubtedly an extraordinarily serious public health policy issue because the implications for people with the condition without treatment are serious. We definitely need a national debate on this illness. To tackle this public health crisis we need greater awareness, more services and more preventative work.

It is regrettable there is not a greater focus on preventative medicine and health promotion. At a time of scarce resources in particular, as well as at other times, it is important that health promotion is given a high priority. The figures for the incidence of obesity among children are startling. The increase in the incidence of obesity is also startling, it being one of the predisposing factors for diabetes. Preventative action and working with parents, teachers in schools, general practitioners and people in any centres where young people gather to try to influence young people's attitudes towards a healthy lifestyle and healthy eating is critical. I again call for the implementation of the expert report on obesity because we must examine the taking of preventative action in this area. That is critical.

Approximately 5% to 10% of all people with diabetes will develop sight-threatening retinopathy. It is a major cause for concern that up to 50% of persons with type 2 diabetes have retinopathy at the time of diagnosis. This highlights the delay in diagnosis of diabetes at an early stage.

As the Minister of State will be aware, when money was allocated to extend the mobile screening service in the north west, it could not be delivered at that time because of the recruitment ban. She might update the House in that respect. That may be the matter to which she was referring towards the end of her contribution.

I note that in the programme for Government neither Government parties considered that a national diabetes strategy merited a mention. This issue needs to go higher up the priority ladder in terms of our public health policy. There has been some apathy and a lack of urgency in addressing this serious public health issue. I welcome that the Leader placed this matter on the Order Paper for debate today. I hope we can create greater awareness about this illness.

We have the expert group report on this illness. I understand it is working on an ongoing basis. The Minister of State might clarify that. I thank its members for their work. The role of such expert groups is important in pointing the way. What is happening in terms of the implementation of the report's recommendations? The Minister of State might give Members more detail on their actual implementation. We know what the recommendations of the report from the diabetes expert group published last November indicate. They state that real savings can be achieved in health care costs by preventing the complications of diabetes, that patient education is very important — a point I have repeated — patient education and community empowerment are critical, linked to GP care and specialist care, and that a regional model of care is recommended for children and adolescents with diabetes. It also recommends a framework for a national diabetic retinopathy screening programme for Ireland which is clearly essential. It is sad to think of people who have lost their sight who, with proper treatment, early diagnosis and intervention, would not have done so.

Will the Minister of State, when replying, outline the plans for the full roll-out of the diabetes screening programme, as recommended by the expert advisory group? If the necessary public funds for the programme are not available, which is what the Minister of State appears to be saying, are there any other plans or is she considering other methods of delivery such as public private partnerships to deliver the screening programme? The shortage of ophthalmologists is an issue in rolling out this programme. Are there plans to train and upgrade the training of this group of people to ensure the incidence of retinopathy can be identified? What is the future role of the expert group?

The issue of screening makes complete sense. It will save the State and the health system money and it will also save people's sight. I saw in some research material on diabetes that the cost of the illness to the State is €350 million. I also saw figures for the cost to the State of people who are being treated for conditions such as foot ulcers as a result of diabetes. The cost in this instance is high. It can cost up to €40,000 per person for people who need inpatient treatment. This illness can have extraordinary implications. A recent "Prime Time" programme covered the case of a very young woman who lost the sight of one eye because of a lack of treatment and screening. What is the plan for the implementation of the expert group's report? A renewed sense of urgency and priority needs to be attached to the issue of diabetes and its screening. Prevention and early diagnosis needs to be emphasised if we are to minimise the serious effects of this illness and maximise the chances of successful treatment and containment.