Nicky McFadden (Fine Gael)

I welcome the Minister of State to the House. While I think it is important to debate this issue, I found the wording of the motion quite strange. I acknowledge the improvements in this area and the fact that a strategic policy has been developed to tackle diabetes, but I find it strange that it is the Government that intends to encourage the HSE to continue to develop and roll out the services. The Minister for Health and Children has responsibility for the HSE and it should be she who ensures this policy is rolled out. I acknowledge the work done by Dr. Velma Harkins in rolling out a policy and strategy for general practitioners and primary care services.

We have all received letters from people who suffer from diabetes. I believe the various associated conditions, such as ulcers, that eventually lead to amputations can be prevented and I do not understand how we are spending €4 million in Westmeath alone on the treatment of preventable diabetic foot disease. Of some 250 Westmeath people admitted for treatment for foot ulcers, one third have diabetes. As Senator Feeney said, much diabetes could be prevented through having a proper, healthy lifestyle. It is not difficult to have a healthy lifestyle, but education on this starts in the schools and with parents. We must educate parents on how to rear children on a healthy diet, on the importance of avoiding processed food and of taking proper exercise. Having worked in the health care area for ten years, I am acutely aware of the number of people who suffer from late-onset type 2 diabetes. This is due to lifestyle - drinking too much alcohol, eating too many processed foods and not taking enough exercise. Education on this, not through occasional advertisements on television but through GPs and primary care teams, would prevent the need for many foot and lower leg amputations.

Some people die from diabetes as a result of neglect. I agree that the worst offenders for getting themselves checked out are men. As Senator Twomey said, if we had a proper roll-out of a strategic plan, like those for breast or cervical cancer, diabetes could be detected early. It would be easy to roll out such a programme because the one blood test required could be taken when people attend for their health check-up. People identified as being in danger of developing diabetes could modify their diets in order not to become insulin dependent. I endorse what others have said and urge continuing improvements in this area. The good policies and plans that have been prepared should be implemented through the primary care system, practice nurses, awareness campaigns in schools and education of parents on providing and preparing proper food.

I and some of my colleagues are involved in the ongoing safefood programme in Leinster House and I commend the safefood team on the excellent programme it is rolling out and on its awareness campaign on television and through us. One hopes the fact that politicians are involved, as in "Operation Transformation", in trying to live a healthier lifestyle will encourage others. I, for example, have stopped taking my blood pressure tablets since I lost weight. If people modify their lifestyles, which is good for their heads and minds, take exercise, stop eating the wrong foods and stop drinking too much alcohol, they will feel better and prevent the development of conditions associated with diabetes. It is all about prevention, which is far better than cure.

It is extraordinary how much money and how many days are lost from work because of diabetes. This helps us understand the need for a screening programme. Far less money would be needed for podiatry if we had such a programme. I know how difficult it is to cure an ulcer for someone suffering from diabetes. It is almost impossible. Diabetic ulcers are very painful and I commend the nurses and doctors who treat people with such ulcers. These ulcers are preventable and I do not understand why an awareness campaign is not rolled out. One out of every 20 people in the country suffers from diabetes and it only stands to reason that the roll-out of a programme would save the country money. It would make economic sense not just to encourage the HSE but to mandate it to roll out a screening programme. This would be a wise move, would be money well spent and would reduce the number of people who lose limbs.

I cannot stress strongly enough the need for this programme. I have seen people attend clinics for months in an effort to cure their diabetic ulcers. Some of these people end up having to have toes, feet or legs amputated. Diabetes also affects people's eyesight. These problems result from neglect due to poor screening. While I welcome the developments there have been, there is much more to be done.