Niall Ó Brolcháin (Green Party)

I welcome the Minister of State. She is a regular visitor to this House and is always very welcome.

Listening to Senator Twomey, I find it difficult to disagree with much of what he said. There is absolutely no question that prevention is better than cure. Indeed, the national diabetes programme 2010 has five major points to it, the fourth of which is to facilitate integration of diabetic services between primary and secondary care. I fully agree with him that diabetic services should be integrated into primary care. The programme the Government is undertaking to ensure the primary care teams are being rolled out around the country is important. The reality is that the focus on primary care is fairly new in our society. The Government is putting this programme in place as we speak.

In Galway roughly 16 of the 26 primary care teams have been put in place at this stage, but the integration of diabetic services into those teams is important. The other four items in the national diabetes programme 2010 are to establish a national diabetic retinopathy screening service, to establish a national diabetes register, to progress footcare services nationally and to develop strategies to improve diabetic control and risk reduction to prevent diabetic complications.

It is the policy of the Green Party - I have been involved in putting it together - that we need to increase significantly the proportion of health spend on preventative care. Indeed when I met the Finnish Minister for Health I asked her what the key issue was that fomented her country's change from having a very poor health service to a good one. She stated the key was increasing the health preventative budget from about 2% to 10%. Every government should be seeking to increase the amount of money spent on health prevention.

Diabetes has been around for a very long time. My grandmother was three years old when her mother died from diabetes in her twenties. That was something which always affected my mother, and indeed the whole family. It was always talked about. Only a few years after my great-grandmother's death insulin was discovered as a method of treatment. We have come a long way since then, thank God, but as Senator Twomey pointed out, there is still a long way to go.

One in 20 people approximately is affected by diabetes in Ireland, equating to eight Deputies and three Senators, roughly. That is probably accurate. There a number of Oireachtas Members who struggle with diabetes. Senator Twomey is absolutely right that a healthy lifestyle is crucial and that there is not enough emphasis on it. That is absolutely true and there has to be much more emphasis on that. One can criticise this Government or go backwards, but the reality is that prevention is better than cure. No Government in recent years could hold its head up high and say it had implemented a necessary programme with great aplomb.

I listened carefully to Senator Corrigan. She made some important points in relation to the work being carried out. In 2005, for instance, the health care skills monitoring report was published which examined a range of health care grades, including podiatrists. As a result of that the National Podiatry School was established in Galway. As Senator Corrigan pointed out, in 2012 the first graduates of that school will graduate. An important campaign is ongoing to ensure those podiatrists are integrated into the primary care teams around the country, and employed by the health service to emphasise that prevention being better than cure is not just a cliché but a reality.

I have examined the economics of this and Senator Corrigan talked about her area. In the Galway region between 2005-09, €11.4 million was spent on treating preventable diabetic foot disease. There were 797 patients from Galway city and county admitted for treatment for foot ulcers in that time and nearly 40% of those had diabetes. Again Senator Twomey is absolutely correct in saying podiatry is not just to do with diabetics. This is very much a lifestyle area we need to look at.

A further 73 people with diabetes from Galway had a lower limb amputation in that period. In any case where a limb is amputated relating to diabetes, that is a failure on the part of the system because the costs are going to be considerably higher if matters are allowed to reach that level. Much better screening programmes are needed. Therefore it is much more cost effective if we can treat diabetes than allowing a situation to develop whereby somebody has to have his or her foot amputated. I endorse calls to ensure podiatry graduates from Galway are integrated into the primary health care system, in line with health service and Government policy. That said, they cannot be integrated until they have qualified. Since 2005, we have recognised there is a problem and we have put in place a policy to ensure podiatrists will be incorporated into the system. Unfortunately, we will have to wait until 2012 before that happens. It is important the primary care teams are set up in such a way as to allow this to happen and everything that can be done in the interim should be done. It is a time of cutbacks but it makes economic sense to go with the policy that prevention is better than cure to ensure people get proper treatment and podiatry is put in place in the primary health care system. I endorse every effort to ensure this happens and that maximum services are provided to people who contract diabetes.