Promised regional paediatric diabetes posts remain unfilled

A call has been made for the HSE West to make additional nursing and dietician support available to enable children and adolescents with type 1 diabetes receive insulin pump treatment at University Hospital Galway.

The advocacy group Diabetes Ireland wants the health authority to channel promised resources into this area saying the therapy improves young people’s quality of life.

It says Ireland continues to lag far behind the rest of Europe in its provision of insulin pumps to treat children and adolescents with type 1 diabetes. The pledged regional paediatric diabetes posts remain unfilled yet the under-resourced regional hospital is expected to cope.

Professor Hilary Hoey, the chairperson of Diabetes Ireland and a paediatrician and endocrinologist, says the insulin pump therapy gives children and adolescents with type 1 diabetes flexibility, it improves their quality of life and can reduce the long-term risks and complications associated with the condition.

“Earlier this year the HSE promised very modest increases in diabetes nursing and dietician support to allow for insulin pump therapy to become available to children and adolescents with diabetes at these hospitals”, she said.

Diabetes Ireland says that the funding for the posts has already been earmarked by making savings in the insulin pump programme in 2011 and 2012. However, the savings have not been passed on to allow for additional critical staffing support which the HSE promised last year.

Children and their parents must learn how to use the pumps before they can begin therapy, explains a spokesperson for Diabetes Ireland.

“It can be time consuming and this is why additional nursing and dietician support is needed.”

Currently insulin pump therapy is only available on a very limited basis in Limerick, Galway and Cork - most children access the therapy through Dublin hospitals. This results in an inundation of referrals from these areas to paediatric diabetes services in Dublin and is matched by the underdevelopment of equivalent regional services.

Now a number of children and adolescents with type 1 diabetes, who had been referred to Dublin for insulin pump therapy, have since been referred back to hospitals in Cork, Galway and Limerick. However, expected resources have not yet been put in place to deal with their care.

“Being referred back to a regional hospital, which is known to be under-resourced to deal with your care, amounts to a withdrawal of the level of care children and adolescents with diabetes had received in Dublin hospitals,” says Professor Hoey. “It places an unrealistic burden on services in Cork, Limerick and Galway and can’t be allowed to continue.”

Parents of the estimated 3,500 children and adolescents with type 1 diabetes lobbied politicians last year calling for services to be restructured on a virtually cost neutral basis.

In response the HSE made commitments to address the “inequity, inconsistency and general difficulty” in accessing advanced therapies like insulin pumps.

“The HSE promised to address this imbalance and build capacity for insulin pump therapy in Cork, Limerick and Galway. I am very concerned at the slow progress being made five months after the announcement,” stresses Professor Hoey.



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