Seanad debates

Tuesday, 23 May 2017

Commencement Matters

Health Strategies

2:30 pm

Photo of Gerald NashGerald Nash (Labour) | Oireachtas source

Approximately 40,000 people in this country have Crohn's disease or colitis. I am one of them; I have had this condition since I was 14 years of age. I was diagnosed with it in 1990. As the Minister of State will be aware, the prevalence of this condition is growing and it is very much a condition found in the western world. Alarmingly, most people in Ireland who are diagnosed with the condition are diagnosed between the ages of 15 and 30. In that respect, at least from a diagnosis perspective, it is very much a young person's condition. It is also very striking that cases in Ireland among children have trebled since 2003.

We are not certain of the causes of this debilitating and often life-altering condition but we can be certain of some matters. We know from a research report entitled Gut Decisions, published two years ago, that inflammatory bowel disease, IBD, costs the health service as much as €185 million a year. In Ireland, 90% of patients with inflammatory bowel disease are hospitalised within five years of their diagnosis. The international average is about 85%. A staggering 49% of people who have inflammatory bowel disease have either lost or have had to give up their job as a result of their condition. That is quite a staggering statistic. Behind each and every one of those stories lies a personal story of difficulty, loss and financial consequences.

We also know from talking to medical professionals and from the research undertaken in this area that one of the greatest barriers to the delivery of better patient care is the absence of a sufficient number of specialist inflammatory bowel disease nurses. It is sad to say that, unfortunately, not a single one of the recommendations made in the Gut Decisions report published in 2015 appears to have been progressed or implemented. That is why it is critical that the Government undertakes to explore the idea that we should have a coherent, cogent national strategy to deal with Crohn's disease and colitis. If, for example, we doubled the number of inflammatory bowel disease nurses - currently, there are on 12 wholetime equivalents but we need 24 to 28 - this would remove a great deal of pressure from emergency departments and from our acute hospital care settings.

Last Friday was World IBD day and I joined the Irish Society of Colitis and Crohn's Disease, Professor Colm O'Morain, and other experts in the field to call for the doubling up of specialist IBD nurses. These are, essentially, expert nurses, located unfortunately only in 48% of the hospitals across this country, who are at the end of a telephone and can assist people with their medication, dietary plans and with other very basic interventions, which would prevent a Crohn's disease or colitis patient from having to queue in a cramped emergency department, where there is often a difficulty in terms of accessing toilets, and can manage their conditions much better in what we might describe as a primary care setting or primary care intervention.

We need a coherent national strategy to deal with this condition that is growing in prevalence by the day. One of the first steps we could achieve in doing that is to commit to spending as little as €1 million annually to provide for the doubling up of inflammatory bowel disease nurses.


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