Dee Ryan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I welcome the Minister of State, Deputy Naughton, to the Chamber. I thank her for her time.

Cathal Byrne (Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister of State is most welcome to the House. I rise on behalf of myself, the Coeliac Society of Ireland and Councillor Brian O'Donoghue of Carlow County Council. This matter relates to people who suffer both with coeliac disease and with gluten intolerance. The estimates in Ireland now are that approximately one in 100 people - approximately 45,000 people - suffer with coeliac disease, with an estimated 500,000 people being gluten intolerant. The significance is that people find themselves unable to consume and eat wheat, barley and rye. We can imagine all the food that is produced with wheat flour, to which people who are coeliac disease are allergic - wheat flour is commonly used to thicken up and in ingredients in cooking - and therefore we understand that they can find themselves with symptoms which are most commonly like food poisoning. Unfortunately, over time this culminates in significant medical distress. Ultimately, some coeliacs find themselves having anaemia, osteoporosis and other complications.Ireland does not have a screening programme. If people find they are having a reaction to wheat flour, they go to their GP, who performs blood tests, and ultimately they are diagnosed as being gluten intolerant or as a coeliac. Perhaps they might need a scope and further examination thereafter.

Several countries have introduced coeliac screening for children who are under the age of 18. For example, the home of pizza and pasta, Italy, introduced this screening programme in 2023. It found that approximately one in 60 people in Italy, or 1.65% of children who were tested through simple blood tests, were found to have coeliac disease. What is interesting about this is that 60% of those children were undiagnosed prior to screening. I support the calls from the Coeliac Society of Ireland to introduce this measure into Ireland. It is important, as the disease and the significant impact it has on individual people's lives gets better known, that there is an opportunity to screen people with a simple blood test so they can get the treatment and diagnosis that they require in advance. I am interested in hearing the Minister of State's feedback.

Hildegarde Naughton (Galway West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Senator Byrne for giving me the opportunity to update the House on this important matter. I am taking this Commencement matter on behalf of the Minister for Health, Deputy Carroll MacNeill. The Minister for Health and I are dedicated to enhancing Ireland’s population screening programmes, which play a crucial role in our health services by facilitating early treatment and care for many people, thereby promoting the overall health of our community. In this regard, I highlight that any proposed changes to Ireland's screening programmes will be facilitated through established evidence-driven protocols.

The national screening advisory committee, NSAC, is the independent expert group which considers any proposed changes to screening programmes. It assesses the evidence robustly and transparently against internationally accepted criteria before making recommendations to the Minister for Health. The NSAC processes ensure that recommendations are based on solid evidence, which is crucial to maintaining rigorous processes for effective, quality-assured and safe screening programme standards. I must emphasise that any changes to Ireland's screening programmes will always be based on the available evidence and that the benefits of such a change should outweigh the potential harms.

The NSAC received a proposal for the introduction of a national screening programme for coeliac disease in children through its 2023-2024 call for submissions. This proposal was carefully considered at an NSAC meeting in June 2024. On the basis of the information provided in the submission, the committee decided that the proposal did not sufficiently satisfy its requirements for referral to the Health Information and Quality Authority, HIQA, for a full evidence review, also known as a health technology assessment. The Coeliac Society of Ireland requested an appeal of this decision and provided additional information. However, after reviewing the additional information provided, the committee determined that its original decision would be maintained. In explaining the rationale for its decision, the committee noted that there is currently a lack of sufficient evidence to demonstrate additional benefits to the population. The committee also pointed to existing HSE guidelines and established clinical pathways for the early identification of symptoms associated with the condition.

I remind the Chamber that the benefits and harms of introducing a screening programme need to be balanced and must align with the internationally recognised Wilson and Jungner criteria for screening. It may be of interest to note that NSAC holds annual calls for submissions, which invite proposals from all stakeholders and organisations, including members of the public, HSE and other medical professionals, for the introduction of new screening programmes or changes to existing programmes. This Commencement matter is well timed, given that the 2025 call for submissions is due to launch shortly. I invite the Coeliac Society of Ireland to submit an updated application, should it feel that significant new evidence has emerged that would warrant reconsideration by the NSAC. Information on how to make a submission will be available on the NSAC website. I thank the Senator for raising this issue and I will raise it with the Minister for Health.

Cathal Byrne (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for her reply. I am aware that the Coeliac Society of Ireland will be making a submission to that group, looking for this. By way of follow-up, perhaps there is an opportunity here for a pilot programme to look at this in a targeted area and gather more evidence. I have seen first-hand the benefits to individual people who have coeliac disease and are then diagnosed, get treatment and go on a gluten-free diet. I ask that the Department of Health support the Coeliac Society of Ireland's call for a pilot programme when it makes that submission as part of the 2025 call for submissions. I ask that the Department of Health continue to engage with the Coeliac Society of Ireland on this issue. I know it is an important issue for the approximately 500,000 people in the country who are affected.

Hildegarde Naughton (Galway West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Senator Byrne. I will relay that to the Minister for Health. I have no doubt that engagement will continue with the Coeliac Society of Ireland. I reiterate that the NSAC is an independent expert group which makes recommendations to the Minister for Health. It is chaired by Dr. Suzanne Crowe. There is a wide range of expertise on that board. It ensures a rigorous and expert-driven approach for considerations on Ireland's screening policy. To date, six recommendations have been made to the Minister for Health by that committee. Regarding the current NSAC priorities, HIQA is focused on the conclusion of two health technology assessment processes based on requests from the committee to consider the evidence for a proposed age range expansion to the bowel screening programme and the potential development of a screening programme for abdominal aortic aneurysm. Should the Coeliac Society of Ireland feel that there is additional evidence that would justify the NSAC reconsidering its proposal for the establishment of a screening programme for coeliac disease, I would encourage it to submit it, as the Senator said it will do, to the upcoming NSAC call for submissions. I conclude by emphasising that screening is for people without symptoms and if anyone becomes aware or has concerns or worries, they should contact a medical professional, who will arrange appropriate follow-up care.