Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank the Senator for raising this very important issue with which I know he has a personal involvement. He has also raised it over many years. I accept his sincerity and integrity in regard to it. It is an important issue in terms of broader society and the broad planning of our health services. I am delighted that I have been given the opportunity to discuss Crohn's disease and colitis.

My Department recently met with the Irish Society of Colitis and Crohn's Disease and the Health Service Executive, HSE, about patient care for these conditions. There are two principal forms of inflammatory bowel disease, IBD, namely, ulcerative colitis, UC, and Crohn's disease, CD. There is no current data on the incidence and prevalence of inflammatory bowel disease in Ireland. However, it is estimated that approximately 40,000 individuals suffer with IBD.Population based studies from a range of European countries suggest a similar rise in the numbers of new cases in the adult population.

Crohn's disease is a very rare condition. It is estimated that for every 100,000 people, there will be seven new cases of the disease a year. Most cases of the disease first develop in people between the ages of 16 and 30 years, although the condition can affect people of all ages, including children. The disease affects slightly more women than men. The outlook for patients with the disease is highly variable. There can be long periods of remission that can last for weeks or months during which they have no or very mild symptoms, followed by periods during which their symptoms flare up and are particularly troublesome. There is no cure for the disease. However, medication is available that can be used to treat the symptoms and prevent them from returning. Approximately 80% of people with the disease will require surgery to relieve their symptoms, repair damage to their digestive systems and treat the complications of the condition.

Within the acute hospital system, the provision of care for individuals with inflammatory bowel disease is largely undertaken by the gastroenterologist, with individuals who require surgical intervention falling under the care of lower gastrointestinal disease consultants.

While the HSE has no specific programme for inflammatory bowel disease or Crohn’s disease, the work of other HSE programmes will impact positively on individuals with colitis and Crohn’s disease. They include the BowelScreen and endoscopy programmes which contribute to early diagnosis. Given the increased incidence and use of medication, the HSE is working with gastroenterologists and recently established a group to look at developing a model of care for the use of biological agents for the treatment of inflammatory bowel disease. It is estimated that of the 40,000 patients in Ireland with the disease, approximately 8,000 are receiving or require treatment with these agents. This model of care will look at the following areas: the criteria for treatment of inflammatory bowel disease; appropriate prescribing of biosimilars; entrance and withdrawal criteria for the use of these treatments; and appropriate prescribers and centres for treatment. The HSE group developing the model of care has recently commenced meeting and it is anticipated that it will set out the clinical management of inflammatory bowel conditions such as Crohn’s disease and ulcerative colitis. I await the completion of this model of care for the purposes of determining any further action that may be required.