Colm Burke (Fine Gael)
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I welcome the Minister of State to the House. I wish to raise the issue of fibromyalgia and the need for an improved medical service in this area. As the Minister of State will know, this condition involves nerve dysfunction and causes chronic pain and fatigue. People who have the condition suffer a lot from migraine. Restless leg syndrome, irritable bowel syndrome, and difficulty in regulating one's body temperature are all part of fibromyalgia. There is a need for a proper structure to deal with this issue. A group presented to the Joint Committee on Health on this issue in July 2012 and very little progress has been made since. Changes have been made in respect of the recognition of this condition and the need for a planned approach to healthcare in Northern Ireland and the UK.

It is in that context that I am raising the issue of the need for a structure to be put in place not only within the Department of Health and the HSE, but within the Department of Employment Affairs and Social Protection. This Department made a protocol, protocol 6, accessible online. This protocol is a 63-page document dealing with chronic pain and fibromyalgia. People who have this condition have difficulty in getting through the social welfare system in order to qualify for disability benefit or long-term illness benefit. It is in that context that I raise the issue of recognition for this condition and of a planned approach for dealing with patients who have this condition.

Catherine Byrne (Dublin South Central, Fine Gael)
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On behalf of the Minister, Deputy Harris, I thank Senator Colm Burke for providing the opportunity to update the House on this important issue. I took a debate on this issue on the Minister's behalf in the Dáil last week, during which a number of Members spoke.Some of the speakers in the Dáil spoke about fibromyalgia as a disabling disease and how many doctors find it difficult to diagnose at its early stages. I thank Senator Colm Burke for his contribution.

The Minister for Health, Deputy Harris, acknowledges the seriousness of the symptoms of fibromyalgia and the many challenges that people with this condition encounter in their daily lives. The exact prevalence of fibromyalgia in Ireland is not known, but it is estimated to affect approximately 2% of the population with many symptoms which tend to vary from person to person. The main symptoms of fibromyalgia, include pain, stiffness, fatigue and even depression. Anyone can develop fibromyalgia, although the condition typically affects more women than men and generally occurs between the ages of 30 and 60.

Fibromyalgia is a difficult condition to diagnose as there is currently no specific test for it and its symptoms can be similar to those associated with other conditions and unfortunately there is currently no cure. A GP will diagnose fibromyalgia based on the patient having a typical mix of symptoms and ruling out any other conditions that could be causing these.

Treatment for the condition requires intervention from various medical specialists in order to manage its associated symptoms as and when they arise. As fibromyalgia has several different symptoms, no single treatment will work for all symptoms and for all patients. There are, however, a number of treatments that may ease symptoms. It is likely that the person will need to try a variety of treatments to find the most suitable approach for them. This approach to treatment will be decided jointly between the patient and the GP, depending on what is preferred, what is available and what is clinically appropriate for each individual patient. This will normally be a combination of medication and lifestyle changes. Several different healthcare professionals in addition to a GP may also be involved in the treatment depending on the complexity and specific symptoms arising for the individual patient, for example, a rheumatologist or a neurologist. As well as medications that may involve pain medications and antidepressants, there are some other treatment options like exercise, physiotherapy or cognitive behaviour therapy that can be used to help cope with the symptoms of fibromyalgia.

In the context of improved medical care, it is important to note that the national clinical programme for rheumatology in the HSE has produced a model of care for rheumatology in Ireland that seeks to address the needs of patients with fibromyalgia and those of all patients with rheumatological diseases. This model of care aims to ensure that a patient is seen and assessed and treated by the right person, in the right place and in the timeliest manner.

This Government is committed to the expansion of primary care. In line with the vision set out in Sláintecare, the aim is to ensure that all citizens, including those suffering from fibromyalgia, can be offered the right care in the right place at the right time and be supported in their local community wherever possible.

The Minister, Deputy Harris, is aware that there have been calls to include fibromyalgia as a specified condition under the long-term illness, LTI, scheme. These requests have been considered carefully, however, currently there are no plans to extend the LTI scheme. I note that it is proposed that the LTI scheme will be included as part of a review of the basis for existing hospital and medication charges which is to be carried out under commitments given in the Sláintecare action plan.

Those suffering financial hardship may also be eligible for a medical card. In accordance with our overall eligibility framework, this decision is not based on a particular illness, but rather on the overall financial situation of an individual and family. It is important to note that, under the drug payment scheme, the maximum monthly amount that anyone is required to pay for their medicine is being reduced from €134 to €124. As such, all those with fibromyalgia are urged to check their eligibility for a GP visit card and medical card and can apply for the drug payment scheme at their local health office or through mydps.ie. It is the Minister's sincere hope that as many people as possible with fibromyalgia benefit from these measures.

Colm Burke (Fine Gael)
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As the Minister of State is aware and dealt with in her reply, this is a complicated issue. It is difficult because the condition presents in different ways but enough research has now been done to clearly show that this illness is long term and does not resolve. There are 15 different conditions recognised under the long-term illness scheme. We should be trying to take a more planned approach to this condition. The Minister of State was with me on the health committee when we dealt with this issue back in 2012 and, seven years later, we should be trying to take a more proactive and planned approach to dealing with this condition from the perspective of healthcare and through the social welfare system. I ask that this issue is reviewed by the Department of Health to see what new actions can be taken to help people with this condition. It will not go away and sufferers face many challenges, both medically and financially, and therefore we should have a more planned approach to dealing with it.

Catherine Byrne (Dublin South Central, Fine Gael)
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I again thank the Senator for raising the issue. As I said, I took a similar matter for the Minister in the Dáil last week after a number of Members spoke about fibromyalgia. One of the things that came out of that debate was that I approached the Minister about the issues that were raised, particularly around long-term illness. Some of the issues that were raised in the Dáil, and which Senator Colm Burke has raised, are everyday issues that are making it difficult for people with fibromyalgia to even live out their daily lives.

I will bring the Senator's concerns back to the Minister and ask that a more appropriate process be put in place to care for people with fibromyalgia. I will ask about the prospect of putting a step-by-step model in place, under Sláintecare, for people suffering from the disease. It is debilitating. I know two people who have the disease and I know that, on a daily basis, life can be very hard for them.

I understand, after speaking to him, that the Minister welcomed the agreement on GP contractual reform that will see structures to care for patients with chronic conditions in primary care settings from 2020 and will benefit over 430,000 medical card and GP card holders over the next years.

I reiterate to the Senator that I will do my best to convey his concerns and ask the Minister to come back to the Senator on this.