On the day of Budget 2022, Diabetes Ireland would like to thank everyone who supported our Pre-Budget submission call to action to date.
Diabetes Ireland launched its first ever Pre-budget submission in the summer which proposed 8 immediate actions for implementation which we feel are person-centred, cost effective and will improve the quality of life for over 225,000 people living with diabetes and reduce preventable diabetes complications.
Together, we campaigned to highlight the needs of the diabetes community by meeting with TDs and Senators, via media articles and encouraged people to submit Parliamentary Questions to their TDs on one of more of the 8 issues of concern (see more here: https://www.diabetes.ie/advocacy-call-to-action/).
The support of Oireachtas members is essential to help us obtain the deliverable actions and many Oireachtas members have actively engaged with the campaign to date and as recently as last week, we were delighted to see our issues raised during Leaders Questions in the Dail when Deputy Michael Lowry highlighted the deficiencies in services for people with Type 1 Diabetes at University Hospital Limerick.
Addressing Tanaiste Leo Varadkar, Deputy Lowry said that he has been contacted by numerous people across Tipperary regarding their concerns, and that the National media concluded that people with diabetes in the Mid-West Region “are offered a disgraceful service”.
He continued ‘there are 225,000 people with diabetes in Ireland. Of this figure, between 10 – 15% have Type 1 diabetes. People of any age can be diagnosed, however Type 1 diabetes is one of the most prevalent chronic conditions in children and adolescents. Up to five children and teenagers are diagnosed with Type 1 every week in Ireland. We have no diabetes register in Ireland, but according to medical reports the number of adults and older people diagnosed is steadily rising’ said the Tipperary Deputy.
‘Early intervention and specialised medical support structures are key to averting a medical influx of adult patients with Type 1 diabetes also. In addition to being given the proper medication to treat Type 1 (daily insulin replacement), the condition requires expert education on managing diabetes: administration of insulin, glucose monitoring, healthy lifestyle including balanced diet and activity, and the self-management skills for keeping blood glucose levels in range.
‘In University Hospital Limerick the needs of paediatric Type 1 diabetics are being met by a specialist dietitian. There is no specialist dietitian in the hospital to meet the needs of long-term or newly diagnosed adults with Type 1 diabetes. If they are hospitalised, they can receive dietary advice and support from a ward dietitian, but it is not diabetes-specific. There is no specialist care or outpatient appointments for adults with diabetes in University Hospital Limerick. This is not the quality of service you expect from a Centre of Excellence’ he said.
‘It is discriminatory and disgraceful that UHL do not provide pumps that delivers insulin subcutaneously 24 hours a day. Insulin pumps allow for replacing daily injections, to delivering insulin by clicking buttons – these devices are efficient and effective, and give the patient a release from regular injections. With continuous glucose monitoring, which is included in most available pumps now, it also gives those with diabetes and their families safety, and peace of mind’.
Deputy Lowry continued: ‘In December 2020 UHL received confirmation of funding to recruit three additional dietetic posts for the treatment of adult diabetes. 9 months later, these posts are still not filled. The HSE in a typical bureaucratic flourish tell us that the recruitment process for two of these posts is at an ‘advanced stage’, while the process for the third remains ongoing. This is cold comfort to patients, as dietitian’s involvement is crucial for insulin pump therapy education.
‘The UHL staff currently working with people with diabetes are providing exemplary care to patients. They are delivering a service under immense pressure. They need additional support. Adult patients need and deserve access to dietary services and the provision of insulin pumps from UHL. They are living with a life altering illness and need access to the services and supports they are entitled to get in keeping with other patients attending different hospitals’.
‘Patients from Tipperary, Clare and Limerick are being forced to seek private medical care to access the services that UHL is not providing. Tanaiste, what happens to those who cannot afford to avail of a private service?’
In response to Deputy Lowry. The Tanaiste said that he can understand the frustration and anger that people must feel if they are not able to access modern treatments like those available to patients in other regions. According to a recent study on insulin pump uptake in adults with diabetes, it is the lowest in Ireland in Tipperary, Clare, and Kerry (less than 3% vs. 8-10% in Dublin or Galway).
He said that from a Government perspective, funding has been allocated to UHL to hire the specialist staff that are needed. While there is a shortage of specialist staff worldwide, this is a reason for the difficulties in hiring staff, but it is not an excuse for the situation in UHL. ‘I encourage anyone in the HSE and UHL involved in the recruitment process to expedite this process’ concluded the Tanaiste.
Meanwhile, over the summer months the Cross Parliamentary Group on Diabetes met with both the HSE adult and paediatric clinical leads on diabetes with a view to understanding the current issues and working with the diabetes community to highlight the need for improved diabetes services nationwide. They heard the pleas from both clinical leads on the need for a diabetes strategy with multi-annual funding commitments for implementation.
Even though today is budget day, our campaign does not stop here. It will only get stronger as we continue to advocate for diabetes service development nationwide.