Seanad debates

Tuesday, 15 October 2013

Adjournment Matters

Hospital Consultants Recruitment

4:35 pm

Photo of Thomas ByrneThomas Byrne (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Gabhaim buíochas leis an gCathaoirleach as cead a thabhairt dom an t-ábhar an-tábhachtach seo a phlé ar an Athló anocht.

The issue I raise is the lack of a paediatric urologist and general lack of paediatric urology services in the Children's University Hospital, Temple Street. There is a vacancy in the hospital for a consultant urologist. Urologists perform a variety of functions but the specific group I have in mind are children with spina bifida. Children and adults with this condition experience serious problems with many of their internal organs and kidney failure is often the cause of death in people with spina bifida. Only this year, a friend of mine with the condition went to his eternal reward and, as such, I am well aware of many of the problems experienced by children and adults with spina bifida.

The case I raise involves a mother in County Meath with a young child who is unable to have routine tests carried out on her child's kidneys as a result of the lack of a paediatric urologist. I understand it is essential that people with spina bifida have regular standard checks done. These include blood tests for kidney function, renal ultrasound, DMSA scans, bladder function assessments and a number of more infrequent tests such as video urodynamic studies and spinal MRI tests. This type of routine monitoring of patients is not available for young children because of the lack of urologists in the Children's University Hospital, Temple Street, which deals with spina bifida. The position is so bad it is not even possible to see a consultant privately because the country lacks the necessary facilities.

I ask the Minister of State to indicate when a paediatric consultant urologist will be appointed to the Children's University Hospital, Temple Street. People need to be given hope that they will not find it necessary to travel abroad for routine medical treatment and monitoring. I look forward to a positive response.

Photo of Seán SherlockSeán Sherlock (Cork East, Labour)
Link to this: Individually | In context | Oireachtas source

I am taking this matter on behalf of the Minister for Health, Deputy James Reilly, who has been unavoidably detained.

The availability of dedicated urological input is particularly relevant for children with spina bifida, a highly complex physical disability. On average, 30 children are born each year in Ireland with open spina bifida, the most severe form of the condition. Best practice is that there are multiple professionals involved on a spina bifida team. Early intervention by a specialist and local team is essential to optimise long-term functioning of the children in question and prevent medical complications later in life.

The Children's University Hospital, Temple Street, is the national tertiary care centre for spina bifida. All infants born in Ireland with spina bifida are transferred to Temple Street after birth for ongoing neonatal management. Children with spina bifida are seen by a multidisciplinary team at Temple Street which includes a consultant paediatrician with a special interest in spina bifida, a spina bifida nurse specialist and neurosurgery input.

The model of care being developed by the Health Service Executive is to share 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 many complex issues are best managed by the specialist team.

The multidisciplinary spina bifida clinic was established in Temple Street in February 2011. However, there has not been any dedicated urological input to date. A recruitment process was under way in 2009-2010, from which the hospital hoped to recruit a consultant urologist. Unfortunately, the recruitment process did not produce a suitable candidate for the post and a further recruitment process in 2012-2013 was not successful either. However, a new recruitment process is in train. The post is with the national recruitment service, to be advertised by the Public Appointments Service. The HSE is hopeful that this new recruitment process will succeed in hiring a suitable candidate.

While awaiting the appointment of a consultant urologist, spina bifida patients are being reviewed by a consultant surgeon who has been granted honorary status at the hospital. The hospital has also been in negotiations to establish a regular clinic with a UK paediatric urologist. This is complete and dates have been scheduled for 17 and 18 October and in December for visits from the UK paediatric urologist. An appropriate service level agreement is in place.

Consultants at the Children's University Hospital, Temple Street, have identified patients requiring this support. As an interim arrangement, children requiring urgent urological input are prioritised clinically and seen in the United Kingdom under the treatment abroad scheme. All patients are being kept under regular review and are referred to the UK case by case basis for treatment, pending the appointment of a permanent urologist.

This Government is acutely aware of the challenges that patients with spina bifida and urological conditions generally and their families face in managing their care. The Department is committed to providing the best possible health service and will continue to work with the HSE to ensure the best possible outcomes for spina bifida patients.

4:45 pm

Photo of Thomas ByrneThomas Byrne (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Certainly, if treatment is required, that needs to happen, but in many of these cases it is not treatment that is required but the regular monitoring of these patients to prevent the necessity of treatment or to prevent serious injury or death, which unfortunately often results. The HSE and Department should treat it as urgent to get somebody in to monitor these patients and keep them right as best they can.