Brian Hayes (Dublin South West, Fine Gael) | Oireachtas source

I thank Senator Burke for raising this matter and for the way in which he has done it. I apologise on behalf of my colleague, the Minister for Health, Deputy Reilly, who is unable to be in the House this evening. As Senator Burke noted, this is an important issue. I understand Ireland has the highest incidence of spina bifida in the western world and therefore it is important that this issue is highlighted in the House. Were the Minister here he would say that this is a complex issue concerning physical disability. Children with spina bifida have multiple problems caused by the condition. The majority of children and adults with spina bifida have hydrocephalus, to which Senator Burke referred.

Best practice recommends that multiple professionals are involved on a spina bifida team. We know that on average 30 children per year are born in Ireland with open spina bifida, the most severe form. I am aware that early intervention by a specialist and local team is essential to optimise the long-term functioning of these children and to prevent medical complications later in their lives. The Children's University Hospital, Temple Street is the national tertiary care centre for spina bifida and hydrocephalus. All infants born in Ireland with spina bifida are transferred to Temple Street after birth for ongoing neonatal management. The model of care being developed by the HSE involves sharing care between the specialist team in Temple Street and the local team. The best care should be provided nearest to the patient's home with guidance and support from the specialist team. However, it is acknowledged that there are many complex issues which are best managed by the specialist team.

A multi-disciplinary spina bifida clinic was established in Temple Street last year in February 2011. However, I am advised that there has been no dedicated urological input to date. A recruitment process was under way in 2009 and 2010 from which the hospital had hoped to recruit a urologist. Unfortunately the recruitment process found no suitable candidate for the post. However, a new recruitment process is in train and it is hoped that the post will be re-advertised before the end of the year. The HSE is hopeful that the new recruitment process will succeed in hiring a suitable candidate.

As an interim arrangement, children requiring urgent urological input are prioritised clinically and seen in the United Kingdom under the treatment abroad scheme. Where a patient is refused access to the treatment abroad scheme the hospital is currently in final negotiations with St. George's Hospital in London with a view to having that hospital treat children pending the appointment of a permanent urologist. Arrangements are currently being made to have a consultant visit from the UK to cover clinical priorities here. In addition to the consultant urologist post, other key staff will also be required to develop the model of care, including, for example, in the areas of occupational health, continence, nurse management and orthopaedic surgery. A business case is currently being developed by the HSE to progress the matter. The Government is acutely aware of the challenges that patients with spina bifida and their families face in managing their condition. I am committed to providing the best possible health service and will continue to work with the HSE to ensure the best possible outcomes for these patients.