Brian Ó Domhnaill (Fianna Fail)

I raise the issue of diabetes facilities in Letterkenny General Hospital. In Ireland, there are approximately 4,000 children and young adults under the age of 16 with diabetes. Approximately 90% of patients under the age of 16 have type 1 diabetes but, unfortunately, an increasing number of young patients are developing type 2 diabetes. The incidence of type 1 diabetes is also increasing, by between 2% and 3% per year, and experts anticipate that the number will double by 2020.

Type 1 diabetes is a complex condition in children and young adults and it is recommended that care be delivered in multidisciplinary settings, with access to a consultant paediatric endocrinologist, a paediatric diabetes specialist nurse, a paediatric specialist dietician, a psychologist and a social worker. Because of the complexity of the condition and the significant dangers of hypoglycaemia, there can be a clinical advantage in having continuous insulin infusion therapy for children and young adults with type 1 diabetes.

I recently attended a meeting with the parents' support group in Donegal. They have major concerns regarding the future of services at Letterkenny General Hospital. In 2010, the Health Service Executive established a national clinical programme for diabetes with the aim of defining the way diabetes clinical services should be delivered, resourced and measured.

I understand there are two proposed models of care to improve the situation for paediatric diabetes care. The first model comes from the report of the HSE expert advisory group, chaired by Dr. Colm Costigan. This model proposes that care be centralised for each region in a dedicated paediatric adolescent diabetes centre looking after at least 150 children and adolescents. The second model comes from the Diabetes Federation of Ireland. It recommends the establishment of between eight and ten regional networks with three existing Dublin centres acting as territory reference centres and with one third of the national diabetes population being served in Dublin.

The parents of the 160 children with type 1 diabetes who attend Letterkenny General Hospital want to ensure that the services currently available at Letterkenny General Hospital are maintained and enhanced. I understand that discussions are currently taking place at a national level on the diabetic clinical care programme but no decision has yet been made.

A number of things are significant in the case of County Donegal. The county is geographically isolated. If services were to be withdrawn from Letterkenny General Hospital parents and children would have to make a return journey of at least six hours to get the care that is currently being provided in Letterkenny.

Currently, 21 hospitals in the country provide this level of care. It is essential that a consultant endocrinologist be appointed at Letterkenny General Hospital. I understand such an appointment is being considered for January 2012. I raise this issue because I seek some level of clarification as to whether or not that is the case and whether or not the HSE will give the go-ahead to employ a consultant endocrinologist.

Will the HSE approve the appointment of a clinical nurse specialist? Currently, two clinical nurse specialists are employed at Letterkenny General Hospital, working with adults and paediatric patients. What is required is a dedicated nurse who would deal solely with children and adolescents with diabetes. This appointment would be vitally important.

Can the Minister give an indication that the service will be retained at Letterkenny General Hospital? The hospital has the excellence and the ability to provide this care. It deals with 160 children, more than the 150 recommended by the HSE expert advisory group. Given that national statistics predict that the number of children with type 1 diabetes will double between now and 2020, there will be more than 300 children with diabetes in the Donegal region by that date.

I hope progress can be made and that the Minister can give a commitment to the provision, retention and enhancement of the services currently available in Letterkenny General Hospital. I hope there will be a commitment to the provision, retention and enhancement of the services currently available at Letterkenny General Hospital