Dáil Éireann Debate, Tuesday - 11 February 2014
640. Deputy Sean Fleming asked the Minister for Health the eligibility criteria for the provision of dietician services by the Health Service Executive; if these vary across the State; and if he will make a statement on the matter. [6805/14]
Amharc ar fhreagraThere is no statutory obligation on the HSE to provide dietician services.
There are currently approximately 80 community dieticians working within the HSE. These dieticians work mainly in primary care, long stay residential care units for older people and nutrition health promotion in the treatment, management and prevention of nutrition related diseases. Dieticians aim to provide early intervention to those with existing nutritional problems, including disease related malnutrition, diabetes, those on nutritional support and clients with chronic diseases, including obesity.
Dieticians also provide a dietetic service to paediatric clients and their families for the treatment of faltering growth, childhood obesity, food allergies and other nutrition related issues. They also provide a public health nutrition role, improving infant feeding practices through their public health nurse colleagues, supporting community cooking classes and other nutrition prevention programmes across the schools and community setting.
As nutrition related illnesses are on the increase, the need for these services is also increasing. Dietetic services accept referrals from both General Medical Services (GMS) and non GMS clients. Referrals are accepted from general practitioners (GPs) and all members of the Primary Care Team and other network colleagues. They accept self-referrals only from clients wishing to avail of the Diabetes X-pert structured patient education programme and group weight management programmes in the community. They also accept referrals from their hospital colleagues when transferring clients' care to the community. A prioritisation system is in place with malnutrition (adult and faltering growth in infants), home enteral tube feeding, diabetes and paediatric patients being prioritised. However, due to varying staffing levels around the country and the increasing demand in nutrition related diseases, access to dietetic services varies in some parts of the country.
The Dietetic service to the long stay residential units for older people is delivered as part of the primary care service in some areas with a prioritisation system in place. Nutrition Training on malnutrition screening is provided to front line staff by the dieticians. A clinical dietetic service is provided to the units, usually to high priority patients, including those who are malnourished and those on PEG feeding. Access to dietetic services varies across the country with some residential units getting a visit monthly/bi-monthly and some weekly by the dietician, depending on bed numbers and dietetic services locally. HSE dieticians do not currently provide a service to private nursing homes. However, these patients, if mobile, will be seen by the dietician in their clinic.
