Maria Byrne (Fine Gael)
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I thank the Cathaoirleach for selecting this important topic and the Minister of State for coming to the House to address the issue.

I recently met members of a concerned support group which works with diabetics in the mid-west. The issues they raised included long waiting lists, having to wait for appointments and insufficient staff numbers. As late as yesterday, I spoke to somebody who has been waiting for eight years to see a consultant endocrinologist at University Hospital Limerick, UHL. Yesterday, the individual in question received a phone call to say that a diagnosis would be done over the phone on Thursday. While I know this involves the public health system, a wait of eight years is unacceptable.

Diabetes is a very serious condition but it can be managed and people can have a great quality of life. The other day, I attended a briefing in the audiovisual room and I am grateful to the people who contributed. While I know a little about diabetes, I still found the briefing an eye-opener. Meeting members of the support groups has been education for me as regards the current shortages.

How many vacant posts are there for consultant endocrinologists, advanced nurse practitioners, clinical nurse specialists, staff nurses and dieticians in the University Limerick Hospitals Group, ULHG? These staff are very important and play a key role in treating and working with people who are diabetic. Many people have type 1 diabetes, while many others have type 2 diabetes or are borderline diabetic. Having proper staff in place helps people to change their lifestyle and eating habits and prevents the development of type 1 or type 2 diabetes. The person to whom I referred had hair eight years ago but now has none. That person is still waiting to see a consultant, which is a serious situation.This person does not know whether they have diabetes because they have not seen anyone. They have been attending his own doctor but they have waited eight years. That is not acceptable. That is why I put down tabled a question regarding how many vacancies there are and whether they are being filled. One or two nurse practitioner positions have been filled but there are still many vacancies. If the positions are being filled across the sector, how many staff do we expect at UHL in the near future? If vacancies are not being filled, when is it planned to fill them?

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for the opportunity to address the House on this important matter, which I am taking on behalf of the Minister for Health, Deputy Donnelly. I assure the Senator that the Government remains fully committed to improving patient services and ensuring patient-centred care throughout the country. That commitment can be seen through the unprecedented level of funding that is being targeted right across the health service from budget 2022. This investment is benefiting many patients throughout the country and will ensure hospitals can continue to develop the services they provide, including diabetic services in the mid-west region. The University Limerick Hospitals Group has advised that it has made positive progress recently in recruiting staff for the adult diabetic services. Following successful recruitment campaigns a consultant endocrinologist commenced post in UHL in May 2022 and an additional consultant endocrinologist is due to take up post in October 2022. That is welcome, although it is little comfort for the person waiting eight years. It is a positive step in the right direction.

In December 2020, the University Limerick Hospitals Group received funding to recruit three additional dietetic posts for the treatment of adult diabetes. The funding was made available through the national clinical programme for diabetes and these posts include two senior dieticians and one staff grade dietician. These posts have now been filled. The adult diabetes service is also supported by a dedicated team of four clinical nurse specialists, CNS, and staff nurses. Four diabetic CNS posts have been approved for UHL and following recruitment campaigns, all four CNS are now in place. Three diabetic staff nurses are also in post in the hospital.

UHL recently became a dose adjustment for normal eating, DAFNE, accredited centre. Staff training is currently taking place and the University Limerick Hospitals Group anticipates that this programme will commence in quarter 4 2022. It is clear that significant work has been progressed in the hospital regarding the development of its diabetes service and some of that work is ongoing. The group informed the Department of Health that diabetes services continue to be a core focus for it and it remains committed to improving this service for patients in Limerick and across the mid-west.

Senator Byrne has asked clearly for the staffing of the service in a tabular format. Unfortunately, that was not available at such short notice but the Department has advised me to inform her that as soon as it comes to hand it will be forwarded directly to her.

Maria Byrne (Fine Gael)
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I thank the Minister of State of her comprehensive response. I welcome the fact that staffing levels have increased. However, for quite some time there was a limited number of staff and that has created a fear factor among people who have the condition. As I said it is a serious condition but once managed, people can have a good quality of life. It is most welcome that staffing levels have increased in recent times. It is totally unacceptable for people to have to wait eight years for an appointment. I welcome the fact that a second consultant has been appointed. It sounds as though an assistant is due to start. That is most welcome. Staff nurses and nurse specialists are covering other areas as well. The clinic is not run every day of the week.People do not have the confidence, because it was not being run every day of the week, and getting an appointment was driving them to other centres of excellence. While the endocrinologist that is there is excellent, getting an appointment is the biggest problem, because of all the other clinics the endocrinologist has to cover. It is welcome but there is much more to be done. I look forward to the figures coming because there are certain areas where there is a shortage and if staff were there, it would give people with this condition much more confidence to attend the clinics. The shortage of staff was the problem all along so I thank the Minister of State.

Anne Rabbitte (Galway East, Fianna Fail)
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When the HSE provides the documentation, it will clearly outline exactly what posts are filled and the whole-time-equivalence the Senator talked about regarding how often the clinic is run. I hope the HSE's response also addresses pediatric diabetes in order that we know exactly what will be covered. We in Galway travel down to Limerick for the support on its pediatric diabetes site but I know we are backing up down in Galway and I wonder if the post is still filled in Limerick. I look forward to the Senator getting a response on it. I look forward to the Minister getting the response on it and I think perhaps, on return of that, there might be a further Commencement matter taken.