Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister of State, Deputy Jim Daly, to the House. There are so many issues in respect of our health service at the moment that it is very hard to know where to start. However, I will start on a positive note and mention that yesterday was World Diabetes Day. I thought of Senator Butler and how he successfully managed to take his health care into his own hands in order to avoid having to take up to nine tablets a day for the rest of his life. Senator Butler lost six stone and turned his life around in doing so. We all commended him at the time and World Diabetes Day is a timely reminder that diabetes is a most serious disease which will affect an estimated 640 million people by 2040. The majority of those 640 million people will be affected by type 2 diabetes, or adult-onset diabetes. Some 70% of these cases could be prevented through lifestyle interventions, just like in Senator Butler’s case. In these cases, it does not take tablets or operations but a lot of hard work and encouragement to do so. In July, Senator Butler called on the Government to provide for diagnostic testing which would alert people to the fact that they are in danger of developing type 2 diabetes. This testing is currently too costly for many and so I echo Senator Butler's call and urge the Government and the Minister for Health to introduce testing which we all know would save money in the long term.

On an entirely separate matter and one which I was bitterly disappointed to hear about, parents of children with scoliosis have been informed that the planned outsourcing of procedures to France is now not to go ahead. Parents had been told initially that the plan was for 20 children to travel to France for surgery. They have now been informed that treatment in France was offered to some families but those families turned down the option and that, "[u]nfortunately as families declined this offer this will not proceed at this time." I would be very interested to know why there is not a system in place to offer a declined position to another family with another child who is suffering while awaiting a life-altering procedure. According to the Scoliosis Advocacy Network, with which I have been in contact, it has asked other parents and not one family out of approximately 600 has ever had France mentioned to them. In fact, there are many on lists who were never contacted about outsourcing at all.

The goalposts are moving and it is not acceptable. We have gone from a situation where no child was to wait longer than four months for surgery by the year end to a situation where children will be offered a plan. The year 2017 is drawing to an end and still too many children remain on surgery wait lists. For some there is no hope of a date for their surgery before Christmas. They end 2017 as they started it: waiting for scoliosis treatment. I sincerely hope there will be no attempt to spin the figures when the targets at the end of the year are not met.

While I am on the topic of parents having to fight tooth and nail for health care for their children, the initial decision made by the HSE not to fund the life-changing drug Vimizim for children with the ultra-rare disease such as muchopolysaccharidosis is utterly devastating, in particular for the two families whose children are currently in receipt of the drug. BioMarin has agreed to continue providing Vimizim compassionately until 5 December 2017. After this date, vulnerable patients will no longer have access to this life changing drug. The numbers here are minute and I encourage the Minister for Health and the Minister of State to leave no stone unturned with regard to funding this drug. It is a ticking time bomb for these vulnerable patients.

One such patient who was brought to my attention is a girl called Grace McIntyre. Grace is a nine year old girl who has not really known life without Vimizim. She is one of two children in Ireland who are participating in the compassionate programme provided by BioMarin. Grace’s parents are extremely fearful for her future and are living in limbo not knowing what will happen to their daughter after 5 December and the turmoil they are facing is compounded by the fact they do not have any other medication to turn to. Vimizim is, effectively, their only lifeline. Why is it that the HSE cites a lack of clinical data when Vimizim gained licensing approval from the European Medicines Agency in April 2014 and is currently funded by more than ten European countries, including Northern Ireland, which is less than 90 minutes from Dublin.

I welcome the Minister of State's comments on district hospitals and the nursing home sector. It is important to distinguish the two. I would welcome investment in the district hospital network. Those hospitals are a valuable cog in the delivery of a modern health service and should not be seen as a relic of a bygone era. As the Minister of State knows, they facilitate discharge from the acute hospitals sector and prevent admissions to the acute hospitals sector. They often act as an interface between the acute sector and the fair deal, where a person is waiting to go into a nursing home. Not to be too parochial, while the treatment in our own district hospital in Belmullet is excellent - we recently had a HIQA inspection - the building is crumbling. I have been speaking to the Minister about this and lobbying him. We need a new hospital given our distance from Mayo University Hospital, which is more than 50 miles away in Castlebar. These facilities should receive investment, especially given most of them have a quick turnaround time. Patients are not languishing in them for long periods. They are a vital cog that will take the pressure off the acute sector.

The Minister of State mentioned €25 million provided in the 2018 budget for primary care, which is welcome, but it really is a drop in the ocean. I have spoken about this to my niece, who is in her final year of her medicine degree in Limerick. If we want our young graduates to enter the specialty of general practice and to entice our young GPs back from abroad, we need to see at least a partial reversal of the FEMPI cuts. The whole sector has been decimated since the introduction of those cuts. It is a scary figure but 900 GPs will retire in the next five years and young GPs are not there to replace them. We try to be solution-driven. Will the Minister of State consider one proactive initiative, namely, the establishment of a 24-hour emergency line for general practitioners to enable them to access the CAMHS for adolescent patients who may be suicidal? It is a service that is badly needed. In some parts of the country children can wait over a year to access the CAMHS. The service would not be abused. In my busy practice I would not expect to have to ring it more than twice annually. It would ensure young vulnerable patients would be seen within 24 hours and be able to skip the queue because they were suicidal. Far too often they end up in emergency departments, which is wholly inappropriate in terms of their assessment by a psychiatrist. I would appreciate it if the Minister of State would consider that initiative.