Jerry Buttimer (Fine Gael)

Cuirim fáilte roimh an Aire Stáit, Deputy Brady. The motion, to say the least, is weak. It encourages rather than mandates the Health Service Executive and endorses, recognises and acknowledges the efforts being made in regard to public health concerns surrounding diabetes and its increasing prevalence. Senator McFadden was correct when she said in her fine address that this disease is preventible. It is unacceptable that almost one in 20 of our people suffer from diabetes. That is excessive. There is a failure on the part of Government to commit to an awareness campaign or resources.

I know people who have diabetes, some of whom have diabetic ulcers, which is distressing for them. We need to address the issue of podiatry services. Like Senator Glynn I want to pay tribute to the Diabetes Federation of Ireland, Cork for its great work. I raised the issue of podiatry services on the Adjournment Debate a couple of weeks ago. The level of amputations here as a result of diabetes is high. This problem is placing huge demand on services in Cork, North Lee and South Lee. People are being discharged from the HSE services to the care of their general practitioner, which is all fine and dandy but general practitioners do not provide podiatry services, resulting in risk to patients. There has been a reduction in staff complement in HSE Cork. Many staff have not been replaced resulting in our having fewer podiatrists to review patients with feet problems. There are fewer podiatrists to review diabetic patients' feet and, therefore, complications are increasing.

We should look at this issue from a real life perspective. All people with diabetes require a foot review but that is not happening. The discharges should not be allowed to take place because the patients are returning at a later stage with complications. That results in more misery for the patient, more cost to the State and an increase in the number of amputations. We are talking about human beings, not statistics. The motion refers to "endorses the efforts being made" and "encourages the Health Service Executive to continue to develop and roll-out models for the ongoing treatment". This is the model of ongoing treatment we are now talking about.

The expert advisory group recommended increasing the number of podiatrists and the amount of resources. I accept we are living in different economic times but can somebody explain to me how it makes sense to discharge people from a service to which they come back in at a different level that costs the State more money? That is the implication. People are not being routinely reviewed on an annual basis. They come back into the service at too late a stage, as Senator Glynn stated when he spoke about men's health. The negative side of that is that patients lose a limb through amputation and, as the Minister is well aware, the mortality rate is high in that regard. The old cliché, a stitch in time saves nine, applies in this regard. We should put in resources at a front-line level because we have an obligation to look after people.

I will give the Minister a statistic. We had seven to eight podiatrists in the north Lee-south Lee area in Cork but we have only four or five now. That is a reduction in the service being provided. That is at a time when the rate of diabetes is increasing yet we find that words such as "recognise", "endorse" and "encourage" are used in the motion. That has implications for people's personal and social circumstances. I stress the point that the people come back into the service when their condition is at a more advanced stage and with more serious complications.

In terms of the effective control of diabetes, investment in the podiatry service for patients, who are people, would lead to a massive reduction in the development and progression of complications, a reduction in the number of amputations and a reduction in the number of people seeking hospital beds, which would result in savings to the State. That is a win-win situation.

If it were not for people like Pauline Lynch and Charlotte Pearson in Cork and many other parents, we would be in a much less healthy position regarding the provision of services because we have had inadequate funding. People with diabetes have been forced into under-resourced treatment services which prolonged hospital stays and resulted in money being badly spent.

Of the 1,691 patients from Cork city and county admitted for treatment for foot ulcers between 2005 and 2009, one third had diabetes. A further 202 people with diabetes from County Cork had to have a lower limb amputated in that same period. That is a very high figure when one considers that 5% of the population suffers from diabetes.

Better use of the money we are spending in the area and a wiser approach to the patients would lead to a massive reduction in the number of people coming back into the system with complications, reduce the number of amputations and reduce the number of people seeking hospital beds. That would mean we would have a saving to the Exchequer but, more importantly, it would ensure a better quality of life for the patients who matter most.

I hope the Minister will not just take this motion as it appears on the Order Paper. It is a poor motion. In the context of what I have outlined I hope we will talk about people and not outputs and inputs.