Seanad debates
Wednesday, 10 October 2018
Commencement Matters
Health Services Provision
10:30 am
Keith Swanick (Fianna Fail)
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I thank the Minister of State for coming to the House to address the issue of chronic pain, which I deal with on a day-to-day basis in my practice. More than 500,000 people in Ireland suffer from chronic pain, which is pain that lasts longer than three months. The prevalence of chronic pain is approximately 35% of the population. As we know, it increases with age and manual labour. Lower back pain is the most common form of chronic pain syndrome. Some 12% of people with chronic pain are unable to work or have reduced working hours. This is not only a public health problem, therefore, but it also has serious economic ramifications.
When people are in debilitating chronic pain, they often phone their general practitioner from bed because they are unable to get up or move. I have taken many of these calls over the years and visited the patients in question. A pain management clinic, led by a consultant anaesthetist who specialises in pain management, is a viable option for these patients. It is not an ideal scenario to have such clinics located more than two hours away from patients. I am not calling for an accident and emergency department in every back garden but for a much-needed facility to be established in County Mayo, where there is a population of 140,000. Patients in the county and also in County Roscommon are forced to travel either to Sligo University Hospital or University Hospital Galway to access a pain management service. These patients are usually maxed out on oral and topical medications and patches, many of which are opioids which are not good. The GP will be at the end of his or her tether because the patient has maxed out all the medications. The patients tend to be elderly and they may be forced to travel on a poor road network or on an inadequate public transport system.
Pain management clinics provide a vital service and we need one in County Mayo. The Sligo pain management model, for example, has consultant orthopaedic surgeons, consultant anaesthetists in pain management, consultant rheumatologists and specialist physiotherapists all working together as a team. There is an excellent orthopaedic service in Mayo University Hospital. Recently, after many years of campaigning, the decision was taken to provide for a visiting rheumatologist from Manorhamilton. The missing cog here is a consultant in pain medicine.
Increased interdisciplinary pain rehabilitation programmes are essential to improve quality of life and they can reduce the economic burden of chronic pain in Ireland. I ask the Minister of State to investigate the possibility and feasibility of opening a pain management clinic in Mayo University Hospital.
Jim Daly (Cork South West, Fine Gael)
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I welcome the opportunity to provide an update to the House on this issue. Chronic pain is a major problem, which the Senator, who is a practising medic, understands well. He has eloquently outlined the case here for those suffering from the condition. It is important that patients have access to diagnosis and effective pain management programmes as quickly as possible. The delivery of services in the most appropriate environment and location with the required multidisciplinary team expertise is a key element of the Saolta University Healthcare Group's clinical strategy.
Unfortunately, however, there are no immediate plans to commence a pain management service in Mayo University Hospital. The pain management service within Saolta is currently delivered from University Hospital Galway and Sligo University Hospital with a limited service in Letterkenny University Hospital. I acknowledge there are waiting lists for pain relief services at University Hospital Galway and Sligo University Hospital. Improving access to hospital treatment is a key priority for Government and yesterday's budget announced an allocation to the National Treatment Purchase Fund, NTPF, of €75 million in 2019, from which the NTPF plans to fund 25,000 inpatient day-case treatments.
The priority of the Department of Health is to maintain a seamless continuation of the considerable progress made this year into next year. The Department is working closely with the NTPF and the HSE to finalise a coherent waiting list action plan for 2019 before the end of this year.
Keith Swanick (Fianna Fail)
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It is deeply disappointing to learn there are no plans to open a pain management clinic at Mayo University Hospital. While I acknowledge the Minister of State's comments on the expansion of the NTPF, what will inevitably happen is these people will still have to travel to Sligo or Galway to access the service. It is unfair to people who have chronic pain. There are 140,000 people living in County Mayo. A clinic in Castlebar could also facilitate patients travelling from County Roscommon. This issue needs urgent attention and I ask the Minister of State to look at the matter again.
Also, will the Minister of State give an update on the proposal for the 20 additional acute beds in Mayo University Hospital which were meant to be delivered through the modular building unit? Are there any plans for the redevelopment of Belmullet Community Hospital?
Jim Daly (Cork South West, Fine Gael)
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The Senator has shone a light on this issue and I welcome the opportunity to comment on it. I understand the Senator's passion, conviction and ability to comment on such issues as somebody who practises on the ground. That is what this forum is for and what politics is about. It is people like him who bring that knowledge with them to put the focus on the national organisation that is the HSE through the Department of Health. I certainly will do so for the Senator. I will convey his request and strong belief that it is necessary to provide a pain management clinic at Mayo University Hospital. Obviously, there are waiting lists in other hospitals, but I certainly will support the Senator in his endeavours to have such a clinic provided. I will raise the issue with my colleague, the Minister for Health, and the relevant departmental officials. I will also obtain an update from the Minister on the modular beds provided in Mayo General Hospital and the upgrade of Belmullet Community Hospital. I undertake to come back to the Senator on both issues.
Keith Swanick (Fianna Fail)
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I thank the Minister of State.