Diabetes Ireland Donegal Branch challenges the Taoiseach

Diabetes Ireland Donegal Branch challenges the Taoiseach Simon Harris to repair broken promises to improve the diabetes services in Letterkenny University Hospital


On the 18th of April, a statement from Paul Gillespie, Chairperson of the Donegal Branch of Diabetes Ireland to the Taoiseach Simon Harris TD was highlighted by Mr Padraig MacLochlainn (TD) in the Dail. Mr Gillespie was highlighting the critical situation in Letterkenny University Hospital (LUH) in Donegal and the severe under-resourcing of the hospital diabetes unit.


Mr Gillespie outlined that along with other Donegal committee members, they had met Mr Simon Harris when he was the Minister for Health in 2016 and again twice in 2017, where Mr Harris had then outlined ‘that radical changes for future diabetes care nationally were on the way’ and promised he would ‘look into the current staffing levels for diabetes care in LUH’ to limit the long waiting lists at that time (10 months for the first appointment, and 20+ months for the review appointment in 2017). Mr Harris was instrumental in developing the Advance Nurse Practitioner (ANP) posts nationwide for all care paths. Based on the number of people with diabetes receiving care in LUH, of the three ANP’s needed, only one ANP was ever appointed and only in the paediatric diabetes team. HSE and Saolta group continue to ignore the crisis in adult diabetes care services in LUH.


As recently highlighted by the Donegal Branch of Diabetes Ireland, the situation in LUH in 2024 is even worse than it was 7 years ago when the current Taoiseach was Minister for Health and promised major positive changes. Despite our meetings with four successive Ministers of Health over the past 12 years, resources have deteriorated to such a level for Type 1 Diabetes care in LUH that we are concerned that patient safety of care is now beyond critical – wrote Mr. Gillespie.


According to Mr Gillespie, There are currently NO Consultant Endocrinologists (3 vacant posts), which have led to recall waiting lists now over 36 months in some cases, whereas the HSE guideline is that people with Type 1 diabetes should be seen by an endocrinologist every 6 months. There are NO Advanced Nurse Practitioners in Adult Diabetes (2 posts never approved by HSE), which led to the inability to provide structured diabetes education and access to insulin pump therapy, there are NO Podiatrists (2 Vacant posts), NO Paediatric Endocrinologist (never put in place by Saolta despite more than 160 children living with Type 1 Diabetes across Donegal), NO Psychologists, NO Shared Centre of Excellence for Children between LUH & Sligo University Hospital, despite the initial plans to share a centre due to the geographical isolation of LUH, and large population in Donegal. And there is still NO access to adult insulin pump start therapy due to a severe shortage in Endocrinologists for over 10 years now and no adult ANP role. This serious under resourcing will lead to poor patient outcomes, increased hospital admissions and huge increase in the number of people suffering with the many side effects of chronic or frequent hypo- and hyperglycaemia, due to lack of support from multidisciplinary diabetes team, and frequent (bi-annual) and regular appointments.


Diabetes Ireland recently wrote to the Minister for Health Mr Stephen Donnelly, TD, to highlight the critical situation in Donegal and asked for his immediate intervention to set up an emergency plan to put some sort of extra support into LUH in the short term as a matter of urgency.


Without a diabetes register and no epidemiological data, we don’t accurately know how many families live with diabetes, but we know from the last census that the Donegal population is now over 167,000. As the nationally estimated prevalence rate of diabetes is 6%, it can be assumed that more than 10,000 people live with diabetes in Donegal, with approximately 1,000 of those with Type 1 diabetes. Despite that, the resources in LUH are very limited which has led to very long waiting lists, no access to insulin pump therapy and limits access to diabetes education or other technologies (e.g. Continuous Glucose Monitoring), which the HSE acknowledge as gold standard for diabetes management, as it will improve patient outcomes (including quality of life), reduce the risk of developing more serious long-term diabetes related complications and prevent costly hospital admissions, interventions and hospitalisation.


The Donegal Branch of Diabetes Ireland is extremely grateful to the few dedicated staff in LUH that continue to try and deal with the massive waiting lists on a daily basis while severely under resourced.


Diabetes Ireland and its Donegal Branch continue to advocate the need to set up a Diabetes Taskforce to develop a National Diabetes Strategy and diabetes registry to improve health service delivery and workforce planning in diabetes care in Ireland and avoid the critical issues with diabetes care delivery as we see now in Donegal and other places. I look forward to hearing from the Taoiseach in the near future – said Paul.