Maria Byrne (Fine Gael)
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I welcome the Minister of State at the Department of Health, Deputy Jim Daly, and thank him for coming here to discuss such an important issue. Tomorrow is World MS Day and in the past I was very involved in the Limerick and mid-west committee of the MS Society, so I am very aware of its needs. In 2014, the approved recommended number of MS nurses for those diagnosed not only in Limerick but in the mid west was three. Currently, the figure is zero. In 2014, approval was given by the Department but it was very hard to recruit people at that time and it just did not happen. It is now 2018 and the number of patients is growing. There will be an MS awareness day in the mid-west offices tomorrow and people have been invited along to highlight the lack of an MS nurse.

The nurse is responsible for giving advice when symptoms arise with MS patients and is very knowledgeable. Currently, people in the mid west who are diagnosed with MS have to contact a clinical nurse in Cork or Galway and obviously those nurses have their own waiting lists and patients, so it is not always feasible that the patient receives help or support within the timeframe required. Many calls are made to the MS office where there the staff comprises social workers and administrators. These are not clinical nurses or qualified multiple sclerosis nurses and they are not able to deal with the issues and queries. This is a big issue.

The number of people being diagnosed has grown. University Hospital Limerick contacted the Multiple Sclerosis Society this morning to say it would be prioritising this in the coming year but there was no indication that it would be looking to appoint somebody. As I already said, the current recommendation is that there should be three nurses in the area but there is none. I would like to hear the Minister of State's opinion on this issue.

Jim Daly (Cork South West, Fine Gael)
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I thank the Senator very much for raising this issue and I welcome the opportunity to address the House on this matter.

The condition of multiple sclerosis is managed within the HSE clinical programme for neurology. The role of the clinical nurse specialist in neurology is to provide for the care and ongoing management of patients within agreed clinical practice guidelines. In addition to multiple sclerosis, clinical nurse specialists roles in neurology can include a range of specialist services to support particular conditions such as headaches and Parkinson's disease.

I am advised that the UL Hospitals Group recognises the need for a second clinical nurse specialist post in neurology and has approved the further post in recent weeks. A job description for this position is currently being finalised by UL Hospitals Group.

It is expected that the filling of the clinical nurse specialist post will improve and enhance patient care and will assist in the overall continuity of care as well as optimising the quality of service provision. The clinical nurse specialist will be required to work as a key member of the multidisciplinary team and provide physical, psychological and emotional support to patients and their families.

I would like to take the opportunity to draw the attention of the House to the model of care for neurology which has been developed and published by the national clinical programme for neurology in collaboration with consultants, nurses, health and social care professionals and patient support groups. This model of care aims to address the need for strategic development of neurology services in the provision of better care for Irish patients. It, therefore, provides a framework for neurology services into the future which will be delivered within an integrated service approach that is in line with international best practice. While the clinical programme has identified current service deficits in terms of staffing, it has recommended increasing the number of consultant neurologists, nurse specialists, including clinical nurse specialists in multiple sclerosis, and other healthcare professionals. The implementation of the new model of care is a work in progress. The model will be implemented over the coming years and will, it is envisaged, improve access for neurology patients, including patients with multiple sclerosis in the mid-west. UL Hospitals will continue to work with the national clinical programme to progress the implementation of the model of care for neurology in the mid-west and will consider, as appropriate, any additional resource requirements in the context of the 2019 Estimates process.

To conclude, UL Hospitals has recognised the need for a clinical nurse specialist post and will provide funding for this post as a priority this year. Looking to the future, the national clinical programme for neurology has identified certain resource issues regarding neurology services but it is intended to address these deficits through the implementation of the new model of care.

Denis O'Donovan (Fianna Fail)
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I am sure the Senator will want to thank the Minister of State for a very positive response.

Maria Byrne (Fine Gael)
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Yes. The one point I would make is that while it is a neurological specialist nurse that has been approved, an MS specialist nurse is slightly different in that the medication patients with MS take is very specialised and they need a lot of monitoring and care. However, while there is still no MS nurse, it is a very positive response that a neurological nurse will be approved and put in place during the year. I ask that MS as a speciality could also be considered.

Jim Daly (Cork South West, Fine Gael)
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The possibility of appointing an MS specialist nurse can be considered during the recruitment process.