John McGahon (Fine Gael)
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I thank the Minister of State for coming to the House today. Some 20,000 people in Ireland have type 1 diabetes. The latest data from across the globe show and the HSE advice states that people with diabetes face much worse outcomes if they contract Covid-19. The HSE has advised diabetes patients at all stages to try to avoid GP practices and avoid hospitals where they can. However, despite these warnings at times over the past 12 months there has been little joined-up thinking in order to put those patients first and ensure that we have first-class care for them.

Six months ago, at the Oireachtas Special Committee on Covid-19 Response, representatives of Diabetes Ireland specifically recommended that the HSE should develop a clinical consultation service for type 1 diabetes patients and extend flash glucose monitoring devices to all people with type 1 diabetes who have complex needs.However, officials have spent approximately two years, 24 months in total, reviewing the addition of flash glucose monitoring to the long-term illness scheme for people over the age of 21 years. Notwithstanding the risks, the risks continue to grow. While one million people have been vaccinated as of the weekend, we must be mindful that the virus is still with us and in our communities. Even though we are far through the cohort in the vaccination process, those vulnerable patients, including those with diabetes, are still at risk, so the health arguments are clear as well.

Aside from the health arguments being clear, the arguments relating to value for money are even clearer. There are other products on the market which many patients with diabetes have advised me are at least €1,000 per year cheaper. It makes no sense to exclude them in the first instance from the long-term illness scheme. This is why I am here today to say this. It is especially the case when we see the HSE budget is growing and growing. I have spoken to many people in my home county who have type 1 diabetes. They have said it would make total sense to have flash glucose monitoring on the long-term illness scheme for them in the first instance. They have a very clear thought process about this, that it makes sense and is the way forward. I am here today to encourage the Government to add that to the long-term illness scheme in the first instance.

Last weekend, after the Cabinet meeting, we heard the Minister for Public Expenditure and Reform, Deputy Michael McGrath, say, "Right across Government, we need to see an emphasis on reforms and ensuring that we are getting good value for the people's money we are spending." The message is clear about this. It is good value for people's money. If we add it to the long-term illness scheme, it will go a long way towards doing that. I appreciate the help and assistance the Minister of State has given me on this issue. He and his Department and special advisers have always kept the door open to me on this particular issue over recent months. I am happy to take this opportunity to thank him in the House today.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for raising this very important issue. The Covid-19 vaccine allocation strategy sets out a provisional list of groups for vaccination. The strategy was developed by the national immunisation advisory committee, NIAC, and the Department of Health, endorsed by the National Public Health Emergency Team, NPHET, and approved by Government on 8 December 2020.

Vaccine allocation is a matter for my Department and the roll-out of the Covid-19 vaccination programme is a responsibility of the HSE. As the Senator is aware, on 23 February, an update to the Ireland's Covid-19 vaccine allocation strategy was announced. In comprising the initial vaccine allocation strategy, NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death. NIAC has now been able to identify more comprehensively those medical conditions and to distinguish between those which place a person at very high risk or high risk of severe disease if he or she contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.

On 30 March, the Government approved a further update to the Covid-19 vaccination allocation strategy. Based on clinical, scientific and ethical frameworks produced by the national immunisation advisory committee, and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age in cohorts of ten years. The move to an aged-based model better supports the programme objectives by protecting those at higher risk of severe disease first, which benefits everyone most; facilitating, planning and execution of the programme throughout the country; and improving transparency and fairness.

People with diabetes are included in three different groups in the vaccine allocation strategy: group 4, which comprises of people aged 16 to 69 with a medical condition that puts them at very high risk of severe disease and death, including those with diabetes who have a HbA1c level of greater than or equal to 58 mmol/mol; group 5, which comprises people aged 65 to 69 whose underlying condition puts them at high risk of severe disease and death, including all other diabetes, types 1 and 2; and group 7, which comprises people aged 16 to 64 who have an underlying condition that puts them at high risk severe disease and death, including all other diabetes, types 1 and 2.It is important to note that vaccination of group 4 began in March and vaccination registration for group 5 began on 15 April. In addition, vaccine registration for those aged 60 to 64 commenced on 23 April. The national immunisation advisory council, NIAC, continues to monitor on a rolling basis data around Covid-19 and emerging data on the effectiveness of vaccines.

The Senator raised one or two issues not addressed in my statement. I will try to get him answers on them as well.

John McGahon (Fine Gael)
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I thank the Minister of State. I have a couple of asks which I would like the Minister of State to come back to me on in his written response. The first ask is the development of a virtual consultation service. We have seen from the Covid-19 crisis that virtual and online services make sense. Prior to Covid-19 it was more difficult to make that happen, but it makes sense now and we should look at doing that.

The second ask is that the flash glucose monitoring devices be added to the long-term illness scheme. It is really important we do that. It is €1,000 per annum cheaper, the health arguments are clear and the financial arguments are clear. For those basic reasons, we should consider doing this sooner rather than later.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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On the flash glucose monitoring devices, I will raise the matter within the Department, where I am sure it will be considered. The Senator will know that vaccination is recognised as one of most the cost-effective and successful public interventions. The WHO estimates that 2.3 million deaths per annum are prevented by vaccination and a further 1.5 million could be avoided if global coverage of vaccinations improved.

The Covid-19 pandemic has served to underscore the importance of the vaccination programme for the protection of public health on a global scale. It is important to emphasise that vaccination is only one part of our response to the prevention of Covid-19 infection. People who are vaccinated need to continue with all public health measures that have been proven to reduce the risk of infection, namely, limiting social contacts, physical distancing, wearing a mask, hand hygiene, cough etiquette and avoiding non-essential travel until a sufficiently large proportion of the population is immune.