I thank the Deputies for raising this issue, which is clearly of considerable importance and concern to parents in Donegal. I also thank Deputies Mac Lochlainn, Doherty, Pringle and McConalogue for affording me the opportunity to reassure parents of children with diabetes and adults with diabetes that the restructuring of nursing resources for diabetes in Letterkenny will not result in a reduction of current service levels and will enhance patient care by strengthening the links between diabetes care in primary, community and acute settings. I realise this issue, as others have pointed out, is of great concern to Deputy Joe McHugh, who asked me to meet the families concerned, and to the Minister of State, Deputy Dinny McGinley.
As the Deputies are aware, I had the honour of presiding over the official reopening of the emergency department at Letterkenny General Hospital last month and seeing at first hand what can be and has been achieved through the commitment and hard work of management and the entire community around Letterkenny. Despite the pressures and challenges facing our health system there is a determination to move forward to improve what we are doing and to deliver the best outcomes for patients. I had the chance to meet representatives of the parents of children attending diabetes services and I understand the concerns.
As parents we want dedicated resources for our children and, as a parent, I accept this. When dealing with a complex chronic illness such as diabetes we want consistent support. As a doctor, I appreciate the reassurance that such supports can bring. I believe these supports are in place as a result of the restructuring of the diabetes nursing resource in Letterkenny.
I am working from memory but, as I understood it, there was the equivalent of 0.8 time given by the nurse. She is now becoming whole-time but across adult and paediatric care. She is involved with paediatrics at the level of approximately 0.6. However, she will have the additional resource of another clinical nurse on half-time, which means the service is going from 0.8 to 1.1. I realise on paper, as the Deputy has said, this is an improvement and I believe this will be the case, but I recognise that the parents want a full-time dedicated nurse. One of the parents put it to me that they need to be reassured such that at night when something happens, such as a hypo, they can pick up the telephone to talk to someone who knows what they are talking about. It would be wonderful if that person knows the child but that is not always possible because people cannot be on-call 24 hours, seven days per week. That is not reasonable and it is no life.
I have been thinking about what is happening in Sligo and the nursing expertise there and I cannot understand why we have been unable to put together a 24 hour, seven day on-call service whereby people can lift the telephone to talk to an experienced paediatric nurse who can advise them what to do when a child's blood sugar is going off, whether high or low. We will certainly examine that. I have heard clearly what people have said about a centre of excellence north of the Dublin to Galway line and it is something I will certainly look into.
When I was in Letterkenny to officially open the emergency department in early March I spoke of my gratification at seeing the way Letterkenny General Hospital works in partnership with local general practitioners and primary care services to address local population health needs in order that those who need acute hospital care are directed to that care. This approach supports the aims of the national clinical programme for diabetes, including the development of an integrated care programme to improve diabetes control, the development of a chronic disease management programme for diabetes and the reduction in overall bed days for acute hospital diabetic care by 40,000.
I wish to make a particular comment about Donegal. It has always been the case that primary care there has been well supported because of the huge geographic area that it covers. There was a realisation many years ago that a hospital-centred delivery system simply could not deliver for such a wide geographic space. That is why primary care in Donegal is probably more developed than in many places in our country.
I am keen to ensure that our health service provides safe, quality and timely care and this is a priority concern of the Government. I acknowledge sincerely the commitment of the staff of the Letterkenny General Hospital diabetes service to the patients and I believe that commitment is reflected by the interaction I have had with the families, who have nothing but the height of regard and respect for the paediatric nurses. I assure the many families for whom the service is so vital that the addition of an integrated clinical nurse specialist will enhance the quality and timeliness of their children's care.
I will not leave it at that. I have taken on board what the Deputies and families have said and I look forward to meeting them next week. I will be seeking to address the issue as outlined by them as well as meeting the needs and improving the service from their point of view. Yesterday, I launched a new awareness site for Adam Harris, who has set up a site for people with autism. During the event I remarked that the service needs to listen to what people want from it and not only take the view that it knows best about what to deliver for them.
