Colm Burke (Fine Gael)
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I welcome the Minister of State, Deputy Catherine Byrne, to the House. This morning I wish to raise the need for treatment services for persons with lymphoedema. As the Minister of State is aware lymphoedema is a condition of painful swelling in body tissue. It can affect any part of the body but usually develops in the arms and-or legs. Once lymphoedema has developed it is a lifelong condition. The best model of care is for patients to have local access to drainage, bandaging and compression garments. It can occur genetically or following cancer treatment, in particular breast cancer.

Approximately 15,000 to 16,000 people in this country have lymphoedema. I understand a model of care has been agreed in the past month following a report that was produced in March 2018 but finally signed off in the past month. The question now is about the implementation of that model of care. My understanding is that if the model of care is introduced it will generate savings of approximately €13 million per annum in real terms. Rather than people being admitted to hospital for treatment, this is a proposal for continuous care where it deals with issues as they arise and ensures that there are services at a local level for patients. This model is about ensuring that the 15,000 to 16,000 people with this condition stay out of the hospital system but have appropriate care that meets their needs as they arise.

Progress has been made about agreement on a model of care, now the next step is the implementation of this model. I am asking the Minister of State about the planned implementation of this model of treatment.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank Senator Burke for raising the subject of the model of care for lymphoedema and giving me the opportunity to address the House on the matter on behalf of the Minister for Health, Deputy Harris.

Lymphoedema as outlined by Senator Burke is a chronic and progressive swelling of body tissue due to a failure of the lymphatic system. Some of the main risk factors include undergoing extensive surgery, chemotherapy or radiotherapy and-or being overweight or obese. The prevalence of lymphoedema is expected to increase due to our ageing population and increasing cancer incidence and survival rates.

As Senator Burke may be aware, the HSE established a working group to make recommendations for the development of a national integrated model of care for the prevention, assessment and treatment of lymphoedema in accordance with evidence-based practice. The report of the work group proposed a model of care for a lymphoedema treatment service involving specialist and non-specialist care being provided in a community setting, with links to acute services. It advocates the establishment of an integrated treatment structure between acute and primary care services, including the development of specialist lymphoedema clinics in primary care settings, with in-reach services to acute care as required. In general the model seeks to encompass best practice in prevention and early detection, assessment, treatment and support and education and research. The model of care has been completed by the working group and can be viewed on the HSE website from earlier this week. I am advised that it is in the process of being formally approved by the HSE.

On receipt of confirmation that the model of care has been approved by the HSE, the Department of Health will consider the recommendations which it sets out. The Minister for Health, Deputy Harris, is eager for progress to be made on the development of these vital services. In this context, the Minister has instructed the Department of Health to work with the HSE to examine steps which could be taken to facilitate commencement of the implementation of the model of care. Funding allocations for the implementation of the model of care will be considered in line with the HSE's national service plan for 2019. This plan envisages a phased implementation of the model within existing resources.

Officials from the Department of Health and the HSE working group met with representatives of Lymphoedema Ireland last year to discuss lymphoedema services and the development of the model of care. We look forward to further interactions with Lymphoedema Ireland as we work to improve services for lymphoedema patients.

The Minister for Health is determined that progress can be made in 2019 towards improving services for patients with this condition. He is committed to working with the HSE and all stakeholders to ensure that equitable access to high quality lymphoedema services is available to all those in need.

Colm Burke (Fine Gael)
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I welcome the decision by the Department. The Minister of State will be aware that the model of care has been published. Lymphoedema Ireland has worked hard to get it to this stage. It is important that what happened to the GPs in terms of the hard work they did to introduce new ways of dealing with issues to reduce costs does not happen in this regard. This is about saving money and, therefore, it is important that this plan should not be left on a shelf. I intend to follow up on this matter. Regarding savings and better services provision to patients everything should be done to implement this plan at the earliest date.

I accept the Minister of State's response that this model of care was only signed off in the past few weeks but it is important that signing off on it is not seen as progress and that the plan does not remain on a shelf for 12 months or two years. That is not what I want to happen and I know it is not what the Minister of State wants to happen either. I know she wants it implemented. It is important that the Department and the HSE work with Lymphoedema Ireland on the implementation of the model of care plan that has been signed off.

Catherine Byrne (Dublin South Central, Fine Gael)
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I again thank the Senator for raising the issue and I have listened carefully to his concerns. As stated in my reply, the Minister is determined that the process will commence as soon as possible. I do not have exact dates for the Senator but I will bring his concerns to the attention of the Minister and ask that the Senator be updated on what is being done to further the process of bringing into being this model of care for those suffering from lymphoedema. I know a number of people in my constituency who suffer from it. I will bring the Senator's concerns to the attention of the Minister and ask that a more comprehensive response be forwarded to him.

Colm Burke (Fine Gael)
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I thank the Minister of State.