Róisín Shortall (Dublin North West, Labour)

I thank Senator Ó Domhnaill for raising what is both a local and a national issue. There are no plans to remove or downgrade the existing paediatric diabetic service at Letterkenny General Hospital. There are two clinical nurse specialists at the hospital. These specialist nurses work with the adult and paediatric diabetic service and a consultant endocrinologist is scheduled to take up appointment in January 2012. Funding is not currently provided for a dedicated paediatric clinical nurse specialist.

The future development of diabetic services in the State and at each hospital site, including Letterkenny General Hospital, will be determined by the HSE national clinical programme for diabetes. This programme includes the care of children and adolescents with diabetes and was established within the clinical strategy and programmes directorate. The purpose of the national diabetes programme is to define the way diabetic clinical services should be delivered, resourced and measured. A clinician has been appointed to lead the development of the programme, which has as its central aim to save lives, eyes and limbs of patients with diabetes.

Improvements in the care of children and young adults with diabetes are required and, with this in mind, a number of models have been proposed. One such model is suggested by the recent Diabetes Federation of Ireland "Diabetes Action" campaign, chaired by Professor Hilary Hoey, retired professor of paediatric endocrinology in the National Children's Hospital in Tallaght. The second model is from the report of the expert advisory group, chaired by Dr. Colm Costigan, paediatric endocrinologist in Crumlin hospital.

In the context of the national clinical programme, the national clinical leads for diabetes and paediatrics have met to discuss the issues involved in the care of children and adolescents with diabetes. They have set up a working group to assess current services across the country, to agree a model of care and to standardise services across the country. This work will also include work on the provision of insulin pumps and work on policy for prevention and early detection of diabetes in young children and adolescents. The group's work is continuing and will determine the final shape of any model for service delivery.