Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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692. To ask the Minister for Health if his attention has been drawn to concerns regarding the availability of paediatric rheumatologists here with the current waiting list being three years; if his attention has been further drawn to the particular concern for children with Down syndrome associated arthritis; and if he will make a statement on the matter. [41854/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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I sincerely regret that children can experience a long waiting time for Rheumatology treatment, and I am conscious of the burden that this places on them and their families.

Children’s Health Ireland (CHI) has advised my Department that during the initial phases of COVID-19, all face to face hospital outpatient reviews and most of the planned diagnostic tests, including MRI, were deferred in response to the pandemic. CHI at Crumlin have recommenced the majority of outpatient and diagnostic services, albeit at reduced numbers, due to public health guidelines on social distancing.  Currently, Consultant Rheumatologists are seeing a number of patients in the outpatient suite including urgent patients and those who were deferred during the early phases of COVID-19. 

CHI has further advised that there is an active recruitment campaign for an additional Rheumatology Consultant underway. This addition to the medical staff will allow for an increased number of patients to be seen, diagnosed and treatment initiated, as part of the comprehensive Rheumatology service.

In relation to the provision of MRI services, the demand for specialist imaging has increased over recent years due to increased activity and acuity in CHI, as well as an increasing trend to utilise imaging in diagnosis and treatment.  CHI have advised that, uniquely to Paediatrics, younger children and children up to 18 years old with complex needs may be unable to remain still in an MRI for the lengthy periods required to complete the scan, resulting in the requirement for a General Anaesthetic (GA) to be delivered by a Paediatric Anaesthesiologist.  This limits the ability for these scans to be performed outside of CHI hospitals. CHI have confirmed to my Department that each request for an MRI scan is carefully examined by Consultant Radiologists who must prioritise, based on clinical urgency, each case in terms of access to the scanner. 

CHI has advised that patients with Down Syndrome who present to Rheumatology services with suspicion of arthritis are clinically assessed and diagnosed by the clinical team. A cohort of these patients will require an MRI scan based on the individualised clinical examination and recommendation.