Pauline Tully (Sinn Fein)
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Cuirim fáilte roimh an Aire Stáit. This matter relates to paediatric diabetic services, specifically insulin pump services, in Cavan and Monaghan general hospital. I raised it with the previous Minister for Health, former Deputy Stephen Donnelly, in the Dáil on a number of occasions. Parents of children and young people have approached me to say that children with a diagnosis of type 1 diabetes were unable to access insulin pump therapy through Cavan General Hospital and had to be referred to Our Lady of Lourdes Hospital in Drogheda or Temple Street hospital in Dublin. As stated, I raised the issue with the former Minister and, in fairness, he pursued it. I received a letter in May 2023 stating that the service would be expanded to include the provision of insulin pump therapy to children and young people from the Cavan and Monaghan area in Cavan and Monaghan hospital. The previous pathway required onward referral from Cavan and Monaghan hospital to Our Lady of Lourdes Hospital Drogheda and Temple Street hospital.

We were delighted that this treatment was earmarked to be available in quarter 3 of 2023. That quarter and the following quarter came and went and parents were still telling me that insulin pump therapy was still unavailable in Cavan and Monaghan. I submitted a parliamentary question. The reply indicated that services had been expanded to include children in Cavan and Monaghan hospital in quarter 4 of 2023. However, parents were telling me that this had not happened and that referrals were still required. I followed up on the issue with a further parliamentary question, asking why 24 paediatric patients from Cavan and Monaghan were still travelling to Drogheda for insulin pump therapy. I was told that the pathway had been extended but was being managed through Our Lady of Lourdes Hospital in Drogheda. The situation had not changed. One still had to be referred from the diabetic team in Cavan General Hospital to Our Lady of Lourdes Hospital in Drogheda if one wanted access to insulin pump therapy. This was important for children who were quite young and did not want to inject themselves or have their parents inject them daily. Children were meeting one team in Cavan General Hospital and another in Our Lady of Lourdes Hospital in Drogheda. One parent told me about having an appointment in Cavan General Hospital in the morning and another in the afternoon at Our Lady of Lourdes Hospital in Drogheda. That meant a whole day. The child was not in school and the parent had to take a day off work.

I am asking for clarification. Is this service going to be provided in Cavan, as promised by the former Minister and indicated in the first letter I received from the RCSI Hospitals Group?

Malcolm Noonan (Green Party)
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I might have to cut short the Minister of State, if that is okay, because we must finish at 3.30 p.m.

Charlie McConalogue (Donegal, Fianna Fail)
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I will try to be brief in that case. I thank the Senator for raising this matter. We are trying to improve services in Letterkenny General Hospital as well, so I understand what she is trying to achieve and the importance of insulin pump therapy.

I will cut to the chase and speak to the situation with regard to Cavan and Monaghan hospital. As we know, the provision of insulin pump therapy is a highly specialised subspecialty of paediatric medicine and must be led by a consultant endocrinologist. Cavan and Monaghan Hospital and Our Lady of Lourdes Hospital in Drogheda have a shared care model with clear clinical pathways relating to children accessing paediatric insulin pump therapy. The initial set-up and subsequent clinics, which require consultant involvement, are carried out at Our Lady of Lourdes Hospital Drogheda. All other clinics, including a dedicated paediatric nurse clinic and a diabetic clinic, are conducted at Cavan Monaghan Hospital. Prior to this pathway of care being introduced in quarter 4 of 2023, patients requiring insulin pump therapy would have been referred to Drogheda or Temple Street for the entirety of their care and would have had to attend all clinics as opposed to just the insulin pump clinics in Drogheda and Temple Street.

The Government is aware of the needs of members of the diabetes community and the challenges they face. In recent years, there has been increased demand for paediatric diabetic services. That is the position regarding Cavan and Monaghan. Follow-up care is available at Cavan Monaghan Hospital, but the initial appointments and the consultant-led insulin pump appointments take place in Drogheda, in the main, and Temple Street.

Malcolm Noonan (Green Party)
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Unfortunately, we do not have time for the Senator to come in again because of the Order of Business.