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Seanad Éireann díospóireacht -
Tuesday, 16 May 2006

Vol. 183 No. 16

Hospital Services.

I welcome the Minister of State, Deputy Tim O'Malley, to the House. I tabled a similar motion on cystic fibrosis a few months ago and I expect I will table another one in a few months time because one of the weaknesses in politics is that we are good at raising issues but the difficulty is following through on them and ensuring progress has been made.

I seek an update on the progress that has been made in the treatment services provided to people with cystic fibrosis. Those who suffer with this problem form a group that is largely ignored. Dr. Gallagher, who is a leading specialist in cystic fibrosis in St. Vincent's Hospital, said lately there had been no improvement in this area in 20 years. They are not exactly the words we all want to hear.

Although Ireland has the highest rate of cystic fibrosis in Europe we have some of the worst facilities. As far as I am aware, the cystic fibrosis gene is dormant in all of us but it can be activated if two people with this gene have children. It is a serious problem.

I am aware that up to three years ago there was a cystic fibrosis specialist, Dr. Cosgrove, in Waterford Regional Hospital. He retired and, for some reason, was never replaced. A paediatrician looks after cystic fibrosis patients but the patient to whom I refer recently turned 17 years of age and, therefore, is no longer eligible for paediatric care. He has been informed he must travel to Dublin and the first problem he faces is that he will have to wait months for an appointment. In addition, no isolation unit will be available unlike in Waterford Regional Hospital, which provides him with his own room and privacy. Cystic fibrosis sufferers are more prone to infection and it is vital that they should have their own rooms.

The Pollock report was published early last year. It provided an assessment of the current and future need of cystic fibrosis patients and made a number of recommendations. It concluded that fewer units of a more significant size were needed to sustain viable staffing levels and to ensure staff had a sufficient workload to enable them to maintain their skills level. The HSE established a working group following the report and it is due to report shortly. The Government has provided additional funding in this area amounting to €4.78 million, which is welcome but more money needs to be invested. A daughter of one of my constituents in Carlow had to sleep in a chair in the accident and emergency department of Tallaght Hospital recently before being admitted. That is not on, especially given that cystic fibrosis sufferers require regular hospital stays.

Sufferers are also under pressure because organ donations have reduced worldwide following advances in intensive care practices. Michael Scanlan, the Secretary General of the Department of Health and Children recently wrote to Deputy Twomey about this issue. He admitted in the letter that there were 76 donors in 2005, down from 89 the previous year, which is worrying. I look forward to the Minister of State's reply. I hope he will update the House on progress since the publication of the Pollock report and clarify what is the difficulty with the appointment of a consultant dealing with cystic fibrosis at Waterford Regional Hospital.

I am taking this matter on behalf of my colleague, the Tánaiste and the Minister for Health and Children. The enhancement of services to persons with cystic fibrosis has been identified as a key priority by the Minister. As part of the overall funding for health services in 2006, additional funding of almost €5 million has been allocated for the development of cystic fibrosis services. This funding will allow for the recruitment of additional medical, nursing and allied health professional staff, which will greatly improve the delivery of care to persons with cystic fibrosis throughout the country.

Included in the overall funding is an allocation by the HSE of €220,000 to recruit a consultant respiratory physician and support staff for Waterford Regional Hospital, with links to the specialist cystic fibrosis unit at St. Vincent's University Hospital. A paediatric service is in place at Waterford Regional Hospital for children with cystic fibrosis, which is led by a consultant paediatrician. The hospital treats approximately 30 paediatric patients with cystic fibrosis. The need to develop services for persons with cystic fibrosis is widely acknowledged. The Cystic Fibrosis Association of Ireland commissioned a review of hospital services with reference to accepted international standards. The report, which was published in 2005, provided an assessment of need for current and future cystic fibrosis patients. It made a number of recommendations regarding the numbers and categories of staff appropriate for a modern, multidisciplinary cystic fibrosis service. The report concluded that cystic fibrosis care should be provided in fewer units of a more significant size so that viable staffing levels can be maintained and staff have a sufficient workload to maintain their skills.

Following publication of the report, the HSE established a multidisciplinary working group to undertake a detailed review of cystic fibrosis services. The working group was asked to review the current configuration and delivery of services to persons with cystic fibrosis in Ireland. It will also make recommendations for the reconfiguration, improvement and development of those services. The working group is due to report shortly and it will make specific recommendations on a range of service improvements for persons with cystic fibrosis, including the future development needs at Waterford.

Do I take it from the Minster of State's reply that funding has been provided for the recruitment of a consultant respiratory physician? Has the vacancy been advertised? If so, is there a difficulty filling it? Why is there a delay?

The Minister of State said the working group is due to report shortly. Does "shortly" mean weeks, months or years?

I not aware of the exact position regarding the vacancy but I am sure I can find out from the HSE whether it has advertised the position. It depends on the availability of someone with the appropriate qualifications to do the job. The working group will make specific recommendations very soon.

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