Thursday, 13 April 2017
Hospital Staff Recruitment
I see the difficulty. Senator Leyden raised this issue on the last occasion and I can understand why Senators raise this matter. It is a Government decision and I have no say over it. The Minister of State is here and we should allow her to give a response.
I appreciate that but it has become regular practice for the Minister not to attend. This is the third time an important health issue in Donegal has been discussed in the Dáil and the Seanad. Let us remember that it takes many days and sometimes weeks to table a Topical Issue and Commencement matter. It is important and precious to have such an opportunity. The Minister for Health has not appeared before us and been accountable, which is completely unacceptable. I assume that he will read the transcript of this debate. It is unacceptable that he has not come here to answer our questions. With all due respect to the Minister of State, she cannot know all the details about this matter.
The Minister for Health met the Donegal Diabetes Association last December at Letterkenny University Hospital and was made fully aware of the crisis in diabetes care in the county. In Donegal as many as 700 adults and children have type 1 diabetes and 6,000 adults and children have type 2 diabetes. We need a team of endocrinologists and nurse specialists who can deal with children and adults. We need a centre of excellence in the north-west region of Donegal, Sligo and Leitrim. The nearest centre of excellence for diabetes care is in Limerick and the paediatric endocrinologist at Sligo University Hospital has left her position to work in the centre of excellence in Limerick. The Minister has known about this matter since January. The position has been advertised and God knows how long it will take to fill the post. There is no commitment to provide cover, which is the vital issue from a Donegal perspective, in the clinics for children. There are 161 children with type 1 diabetes who rely on the monthly clinics for pump therapy. The pump therapy is the accepted way to deal with diabetes care and prevent long-term issues. Type 1 diabetes is a chronic condition and these children must live with it. We urgently need reassurance that the monthly clinics will continue and that the post will be filled.
The Donegal Diabetes Association has also made it clear that we need to double the number of endocrinologists and specialists at Letterkenny University Hospital. We need to ensure that we have the correct number of specialists to deal with a population living with diabetes types 1 and 2 in the county.I am disappointed the Minister is not present and ask the Minister of State to convey to him the urgency with which he must meet representatives of the Donegal Diabetes Association to provide reassurance on these issues.
Perhaps the Senator might write formally to the Committee on Procedure and Privileges on the issue. I, too, have been annoyed on occasion by the absence of the Minister when I raised issues related to farming, fishing and so on. We cannot, however, pin blame on the Minister of State. I ask her to respond to the Senator on the matter he raised.
The Minister apologises for his absence. I will relay the Senator's concerns about the failure on occasion of Ministers to appear in the Chamber to deal with Commencement matters.
A paediatric insulin pump service was initiated in May 2015. The service is based in Sligo University Hospital, with outreach clinics in Letterkenny University Hospital. The Saolta University Healthcare Group has confirmed that the consultant paediatrician with specialty interest in diabetes who was instrumental in commencing the service is leaving the post in mid-April. It has recently advised the Department that a consultant paediatrician has been appointed to the post on a temporary basis. The permanent post is to be filled through public competition via the Public Appointments Service and this process is ongoing.
To address the issue of continuity, the clinical service arrangements for the management of the insulin pump service are being examined in consultation with the relevant clinical teams. There is one consultant endocrinologist at Letterkenny University Hospital providing the adult diabetes service which serves approximately 700 patients with type 1 diabetes and 6,500 patients with type 2 diabetes. The consultant endocrinologist is receiving support from a locum consultant general physician who has a diabetic interest. Additional clinics are being run on a monthly basis, with one or two extra clinics per month, to address waiting lists for the service.
The major focus in the past 12 months has been on seeing newly referred patients. The overall waiting list for no patients to be seen by the consultant endocrinologist has been reduced by 20% from 313 patients in 2015 to 249 patients at present. More significantly, the number of new referrals waiting for more than one year for a clinic appointment has been reduced by 80% from 97 in 2015 to 19 at present.
With regard to addressing waiting times for patients who require repeat appointments, work is continuing with the diabetic service to address this pressure, while simultaneously ensuring newly referred patients are seen promptly. The Saolta group advises that an adult insulin pump therapy service is provided for patients in the north west. The current number of adult pump therapy patients is 24. However, eight additional patients are transitioning to the adult service, while a further eight will move to the service in three to six months, bringing the number of adult pump patients to 40.
On the future of diabetes services in the north west, the Saolta group advises that a business case is being prepared in support of a second consultant endocrinologist, a diabetic nurse specialist and a diabetic dietician to further support the Lettekenny diabetes service. On the recruitment of health care workers generally, significant efforts are ongoing at national and local level to address staffing issues across the health service. It should be noted that the numbers of consultants increased by more than 130 between February 2016 and February 2017, while numbers of nurses and non-consultant hospital doctors increased by approximately 460 and 230 whole-time equivalents, respectively, in the same timeframe.
I note the Senator's dissatisfaction about the Minister's absence. I will convey to the Minister the various issues raised, in particular, the Senator's view that the Minister should be present in the Chamber. While I am not familiar with the process in place in County Donegal, I have provided a response to the matter raised.
I appreciate the Minister of State's response and ask her to convey to the Minister the need to meet representatives of the Donegal Diabetes Association, as promised, as soon as possible to address their concerns. In her response the Minister of State omitted to mention that there is a 21-month waiting time for repeat referrals for adults with type 1 diabetes in County Donegal. This is a serious issue, given that it has been well documented that diabetes care will prevent long-term interventions such as amputations and long-term conditions such as loss of sight. The paediatrician endocrinologist at Sligo University Hospital has moved to the centre of excellence in Limerick. The failure to deliver a centre of excellence in counties Donegal and Sligo, as justified by the numbers involved, has resulted in the needless loss of top class professionals to another centre of excellence. I reiterate my request that the Minister meet representatives of the Donegal Diabetes Association as soon as possible to assure them that the monthly clinics for their children which offer pump therapy essential to their care will not be lost. We urgently need reassurance on the issue and that the number of specialists in Letterkenny University Hospital dealing with patients with diabetes will increase.