Stephen Donnelly (Wicklow, Fianna Fail)
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Diabetes is a complex condition that can require management across the entire spectrum of healthcare delivery, including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care.

The planned delivery of diabetes services is ongoing. As part of Budget 2023, funding was allocated to implement a number of initiatives aimed at improving diabetes care. This includes the commencement of the development of a National Diabetes Registry, the commencement of a National Paediatric Audit of Type 1 Diabetes, and two further initiatives related to gestational diabetes.

The inclusion of diabetes as one of four chronic diseases in respect of which GMS patients receive ongoing, planned care from their GP through the Chronic Disease Management Programme also represents a major step forward in assisting those living with diabetes to manage their condition. As part of the recently published GP Agreement of 2023, agreement was secured to include all women who have been diagnosed with gestational diabetes or pre-eclampsia since January 2023 in the CDM Preventative Progamme.

Guidelines for Diabetes prevention and management include the Model of Integrated Care for Patients with Type 2 Diabetes, the Model of Care for the Diabetic Foot (2021) and the National Clinical Guideline for the Management of Adult Type 1 Diabetes. Guidelines are reviewed and amended in line with the most up to date evidence to support best clinical practice and standardisation of care for diabetes patients.

In 2020, the Health Service Executive published The National Framework for the Integrated Prevention and Management of Chronic Disease (2020-2025) which adopted a whole system approach to integrated care for people with Chronic Diseases. It sets out a national framework for an integrated approach to the prevention and management of chronic disease in Ireland over the coming years. This framework was developed in relation to four major chronic diseases, including type 2 diabetes. The framework builds on the existing policies and guidelines, with a focus on health promotion, disease prevention, diagnosis, treatment, disease management and rehabilitation services that are coordinated across different healthcare providers and healthcare settings.

I am aware of the needs of the diabetes community and the challenges faced by those living with the condition. Officials in my Department engage with the HSE Diabetes clinical team in consideration of the future development of diabetes related services.

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 640 and 641 together.

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including clinical efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. I, as the Minister for Health, have no role in these decisions.

The Health Information and Quality Authority completed a Health Technology Assessment (HTA) in respect of the provision of glucose monitoring systems to adults with Type I diabetes in Ireland. This was published on 29 September 2023 and will inform the HSE decision-making process.

While preparations in respect of Budget 2024 are ongoing, any health measures introduced will be in the context of the implementation of the health commitments in the Programme for Government and the funding available to progress healthcare priorities.