Thursday, 1 November 2007
Seanad Eireann Debate
Senator Jerry Buttimer: Cuirim fáilte roimh an Aire Stáit. I raise the matter of the provision of paediatric diabetes services at Cork University Hospital. In particular I am asking the Health Service Executive as well as the Minister for Health and Children and her Department to explain why, despite reassurances and promises, there has been a failure to carry out improvements to this paediatric diabetes unit. I raised this matter yesterday on the Order of Business and I have tabled it today as an Adjournment matter because it is of some importance. There is an overriding need to have the required number of staff allocated for this unit which is solely dedicated to paediatric diabetes services. An improvement in that regard is crucial.
I am sure the Minister of State will agree it is unacceptable that a group of parents and children yesterday had to take to the streets outside Cork University Hospital to protest as part of their ongoing campaign for the better quality to which they are entitled. More than 270 children attend Cork University Hospital for treatment. There is just one paediatric consultant and one clinical nurse specialist post operated by two nurses on a job sharing basis. It was not until the eve of the protest that a paediatric dietician post which had been vacant for some time was filled. International guidelines reveal that, in this case, the staffing level is well below what is required. As we all know, diabetes is not a short-term illness but a lifelong illness that will not go away. It needs to be treated using proper staff and a proper hands-on approach.
I accept a specialised dietician was appointed yesterday. Is this person suitably qualified and is the position full-time? Can the Government guarantee a multidisciplinary team solely dedicated to tackling paediatric diabetes will be put in place?
Deputy Trevor Sargent: Ní féidir leis an Aire Sláinte agus Leanaí bheith i láthair agus tá brón uirthi. Tááthas orm go bhfuil an t-ábhar seo ardaithe ag an Seanadóir Buttimer. I will take this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney.
The Minister is aware that the number of children diagnosed with insulin-dependent diabetes attending Cork University Hospital has increased from 122 in 2000 to 275 in 2007. Tá an tAire sásta tabhairt faoi deara go bhfuil an HSE ag méadú na seirbhísí san áit seo.
The HSE has succeeded in recruiting a senior dietician for the paediatric service and a suitably qualified dietician commenced providing the service from Tuesday, 30 October. The funding and whole-time equivalence for the post have been ring-fenced and the post will be established in the hospital in a permanent capacity. A clinical nurse specialist post has been offered to a nurse who is already working in the paediatric unit at the hospital. She will be able to take up duty when her current post has been backfilled. It is likely that approval for her replacement will be granted shortly.
Cork University Hospital provides a service whereby a dietician and the clinical nurse specialist for diabetes attend the general paediatric clinics to see urgent cases of children with diabetes, for example, those who are newly diagnosed, have a new regime or are experiencing difficulties with control. Hospital management assure us that every effort will be made to ensure all the relevant staff attend these clinics.
The HSE is considering the following additional staffing level requirements for the paediatric diabetic service in the south for 2008: 1.2 whole-time equivalent clinical nurse specialists; 0.2 whole-time equivalent dietetic support staff; 0.5 whole-time equivalent consultant paediatrician — a share of one whole-time equivalent who has a special interest in diabetes and endocrinology but also has a general paediatric commitment; and 0.3 whole-time equivalent social worker support — also a share of the general paediatric commitment. These posts would form part of a multidisciplinary team along with the nursing and dietician posts currently being put in place.
The general manager and nurse service manager of Cork University Hospital, together with the business manager for the division of paediatrics, have met representatives of the support group and are fully aware of its concerns over the paediatric diabetic service. The Minister is satisfied that every effort is being made to address those concerns.
At the end of 2006, the HSE established an expert advisory group on diabetes to draw up standards of care for persons with the disease. This process will take account of the document of the Department of Health and Children, Diabetes: Prevention and Model for Patient Care.The group has subdivided its work into six areas: standards of care; retinopathy; paediatrics; education and patient empowerment; podiatry; and the model of shared care. The group will report in 2008 and the allocation of any additional resources for diabetes will be informed by this process.
Senator Jerry Buttimer: I thank the Minister of State for his reply, which I appreciate. I know the matter does not concern his Department. Will he tell his colleagues in the Cabinet that the response is inadequate in terms of the provision of personnel?
Deputy Trevor Sargent: I appreciate what Senator Buttimer is saying. When I agreed to stand in for the Minister, I asked that the blacks of this debate would be examined and that action would be taken on foot of what the Senator would say. He may want to liaise directly with the office of the Minister.
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