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Diabetes Ireland highlight gaps in care for paediatric diabetes

Professor Hilary Hoey, Consultant Paediatric Endocrinologist and Diabetes Ireland Chairperson has stressed that the Government urgently need to fund The Model of Care for Children & Young People with Type 1 Diabetes, to enable implementation of the plan they endorsed in 2015. The plan is currently failing due to lack of commitment and urgency by the Department of Health, claim Diabetes Ireland.

The Model of Care document, which continues to be supoorted by Diabetes Ireland, mapped out the development of a quality paediatric Type 1 diabetes service, placing children and their family at the centre of their care plan.The society have pointed out that, to date, several of these centres of excellence intended to provide support to local outreach centes in Cork, Waterford, Limerick, Galway, Sligo, Drogheda and Dublin have unfilled consultant posts, even where funding is available and existing teams are severely understaffed.

Professor Hoey said: “It is very frustrating to see posts for which funding has been made available, still vacant two years on”.

In Waterford, the vacant Consultant post was advertised last year and it took over six months for interviews to be held and may be up to a further year before the position is filled. A replacement has also yet to be recruited following the transfer of a Consultant from Sligo Hospital to Limerick University Hospital.Galway University Hospital are waiting for interviews to take place for the vacant Consultant post there, recently re-advertised after the withdrawal of a successful candidate who was returning from abroad and who had accepted the post in 2015 and was due to start in 2017.

Professor Hoey claimed that parents of children attending these centres are increasingly seeking a transfer to the Dublin Hospitals Temple Street, Tallaght and Crumlin, all of which already have caseloads in excess of what they can meet.Professor Nuala Murphy, Consultant Paediatric Endocrinologist, Temple Street Hospital said that they are: “struggling to provide optimal care”. She has called for the urgent establishment of three new paediatric diabetes teams in Dublin.Currently, the Dublin Centres have long waiting lists for children to access insulin pump technologies.

While funding for insulin pump devices is available for all patients, often there are delays in accessing pump technology. Insulin pump initiation requires intensive training and early support in the initial three months of use and staff deficits prolong this wait. Structured education programmes for children with diabetes and their families have been developed but fail to be uniformly delivered nationwide, due to staffing shortages. Professor Murphy explained that attraction and retention of highly qualified consultants is difficult when health services from other countries can offer a better work/life balance and better working conditions.