Health Services

93. Deputy Sorca Clarke asked the Minister for Health the steps she is taking to restore the Mullingar diabetic day centre. [72024/26]

The adult diabetes service day centre in Regional Hospital Mullingar has been suspended since the beginning of October because of unfilled specialist nursing and dietician posts. Patients have lost access to that specialist support, education and insulin pump training. The staffing crisis was known about well before the beginning of the October, before the service was forced to close, because the dietician actually left in March. When will this service reopen and when can those patients have access to it?

I thank the Deputy. I have met some of the team of the adult diabetes multidisciplinary service at Regional Hospital Mullingar, who provide excellent care in both scheduled and unscheduled access to specialist diabetes nursing and multidisciplinary support for patients with both type 1 and type 2 diabetes. The Deputy is of course correct that the hospital had to temporarily suspend the adult day diabetes service with effect from 1 October 2026. There are currently four vacancies within the diabetes day service team. The team should comprise four full-time nursing staff and one full-time dietician. Recruitment is under way within the HSE to fill the posts. It is hoped these appointments will be confirmed and the service restored as soon as possible. I cannot give the Deputy a timeline on that because until the positions are confirmed, I do not want to say something that I do not know to be correct. Recruitment is under way and we hope those positions will be confirmed and the service restored as soon as possible. In the meantime, measures have been put in place to try to ensure the best continuity of care for patients. Existing patients will continue to be managed through consultant diabetes outpatient clinics, with those requiring more intensive support prioritised for earlier or more frequent consultant-led follow-up, where required. For the consultant-led diabetes outpatient service, referrals that have already been accepted to that service will continue to be managed and existing referral pathways to the community diabetes service will remain available. Our priority is to recruit for those positions and have them in place as soon as possible.

That will be very cold comfort to the service users who are there at the moment. I do not know if the Minister saw the Westmeath Examiner this week but it makes for really difficult reading. A member of the Westmeath branch of Diabetes Ireland is quoted as stating: I was just sickened when I heard, and thought about the work we put in as a committee, the money we pumped in doing fundraisers over the years ... If I keep going, I'll draw tears ... I am told 600 people use this service and 200 people are waiting on pump training in that service alone. The Tánaiste told this House last week that the suspension must be kept as brief as possible and that alternatives, including redeployment, should be considered. Has any redeployment been considered in this case specifically? It is not the first time a diabetes service in Regional Hospital Mullingar has been forced to close or been threatened with closure. When the patients and service users hear "temporary", what they feel in their bones is that it will be indefinite.

I understand those concerns. I understand also the level of fundraising and community support that has gone into the service and I acknowledge that too. I do not know the answer to the redeployment question but I will check with the regional executive office and come back to the Deputy on that. Redeployment would be better in the region given that it has an overspend. Mullingar, in particular, has a very high agency profile. It is not just about cost; it is not good for the stability of the workforce or for the best patient care. The region and Mullingar have made better efforts this year than in any other to convert agency staff and make more permanent. That is what we want to do. There is a very significant opportunity there, both for redeployment and for offering permanent positions - I hate the word "conversion" - to people who were working on an agency basis . Let me check that and I will come back to the Deputy, but it is our priority that this service be re-established as quickly as possible.

The Minister indicated that consultant outpatient appointments will continue and that is obviously to be welcomed. However, that is not a replacement for that specialist, nurse-led service that was provided already through the clinic that is there. The HSE has also confirmed those clinics cannot accept new consultant-led diabetes referrals during the suspensions. That is actually quite frightening for services that are there. Ultimately, this is a slap in the face for the service users who are there and particularly those who are struggling to come to terms with a new diagnosis and learning to live as a diabetic. The other side of it is that it was over 20 years ago that the Mullingar branch of Diabetes Ireland met with a Minister for Health - at the time, it was Mary O'Rourke - to have this service established in Mullingar. It is not an unreasonable expectation for a committee such as that, having gone through the fight and battle to have a service established, that the service will continue to provide care in the community.

I thank the Deputy. The whole point of this service is to provide holistic management for patients with diabetes. As the Deputy says, that includes people being trained or waiting on insulin pumps and the dose adjustment for normal eating education programmes. These are the impacts and this is a good service that really supports people in an holistic way. We really want to make sure it is re-established. The vacancies are there, we are trying to recruit and I will discuss it and get a correct answer. I do not know the answer to the redeployment question and I need to speak to the REO about that. I recognise and completely acknowledge the concern among patients and families, along with the very active and successful group in the community that have wanted to support them for such a long time. I really accept and agree with what the Deputy is saying. We need to find a solution to it.

Quickly.

I agree. With recruitment for specialist posts, if somebody is in a position in a different place and there are notice periods, it can be more difficult than recruiting a nurse who is not in a specialist position, but we still need to have it.