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 Header Item Fibromyalgia: Statements (Continued)
 Header Item Saincheisteanna Tráthúla - Topical Issue Debate
 Header Item Childcare Services

Thursday, 4 April 2019

Dáil Éireann Debate
Vol. 981 No. 5

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(Speaker Continuing)

[Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly] They suffer in silence. The chronic pain people suffer has already been described; I do not need to go into it. I am in receipt of the same emails as everyone else, emails in which people describe what it is like to live with a debilitating ongoing condition. It would be good if we had something positive to say to those people as a direct result of this debate.

Minister of State at the Department of Health (Deputy Catherine Byrne): Information on Catherine Byrne Zoom on Catherine Byrne I will make some remarks after I have read from the written statement. This is not my remit; I am here on behalf of the Minister, Deputy Harris.

Deputy Gino Kenny: Information on Gino Kenny Zoom on Gino Kenny The Minister is like the invisible man these days.

Deputy Catherine Byrne: Information on Catherine Byrne Zoom on Catherine Byrne That is the Deputy's opinion. I cannot comment.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly The Minister of State is here however.

Deputy Catherine Byrne: Information on Catherine Byrne Zoom on Catherine Byrne I thank Deputies for their contributions to the debate on fibromyalgia. I acknowledge the personal challenges faced every day by persons with the condition. I thank the many people who have shared their experience of the condition with Deputies and with myself. As was outlined earlier, fibromyalgia is a difficult condition to diagnose as there are currently no specific tests for it. Symptoms replicate those associated with other conditions. There is currently no cure for this condition as its cause is unknown. Treatment of the condition requires intervention from various medical specialists in order to manage associated symptoms when they arise. This was outlined by Deputy Harty.

To help sufferers of this condition with the cost of their treatments, I reiterate that any patients are eligible to apply for the drug payments scheme or a medical card. Under the drug payments scheme, no individual or family pays more than €124 a month towards the cost of appropriate prescription medicine. The scheme significantly reduces the cost burden on families and individuals who incur expenditure on medicines. People who cannot without undue hardship arrange for the provision of medical services for themselves and their dependents may be entitled to a medical card. In the assessment process the HSE can take into account medical costs incurred by individuals or by their families. People who are not eligible for the medical card may still be eligible for a GP card, which covers the cost of GP consultations. General medical services are provided by GPs. If the patient's clinical condition warrants referral to a consultant, the GP will organise that referral for the patient.

While there are no plans currently to add fibromyalgia to the list of conditions covered under the long-term illness scheme, patients with a condition not listed under the long-term illness scheme are eligible to apply for the drugs payment scheme or a medical card. It is proposed that the long-term illness scheme be included as part of the review of the basis of existing hospital and medicine charges to be carried out under the commitment given in the Sláintecare implementation strategy.

I am aware that a number of parliamentary questions have been tabled in respect of disability services. Access to disability services is based on need rather than on diagnosis. Our current health policy promotes a non-condition specific approach to disability service provision based on the needs of the individual rather than on a specific disability diagnosis.

It is interesting to note that self-help for fibromyalgia is important and that there are several lifestyle changes which can help to relieve symptoms. A GP or other healthcare professional treating a patient will typically be able to give advice on and support in making these changes a part of the patient's everyday life. As the Minister of State with responsibility for health promotion, this is an issue that is close to my heart. Promoting the health of the population to prevent illness is an essential part of the Sláintecare strategy. As I announced earlier, €50 million has been allocated to primary care services in the Sláintecare strategy. These additional resources will enable a range of measures to be advanced, including the recruitment of additional therapy staff in psychotherapy and occupational therapy. Last month we published the 2019 Sláintecare action plan, which includes a plan to continue the implementation of Healthy Ireland across Government and wider society as well as within the health service. The Sláintecare action plan also sets out our ambition to build on our engagement with citizens on how they can empower and enable themselves to look after their own health and well-being.

The speech I read was written for me but I would like to add a few remarks. As always, I have listened carefully to the concerns raised, to the views expressed, and particularly to the personal statements which some Deputies spoke about this afternoon. In response to Deputy Gino Kenny, I am a not a doctor so I will not comment on medicinal cannabis or its uses. The Deputy mentioned in his speech that in 2016 fibromyalgia was brought under the equivalent of the long-term illness scheme in our neighbouring countries. I will mention that to the Minister. I will also mention that the World Health Organization and the European Parliament have recognised fibromyalgia as a long-term illness. With regard to his appeal for me to meet with himself and other Members on a cross-party basis, I have no problem in doing so but I believe the Deputy should meet with the Minister, Deputy Harris, because this issue does not come under my remit. I have been asked to step in this afternoon. I give my personal commitment that I will sit in on any meeting between the Minister and the Deputy. I will bring the Deputy's requests to the Minister.

That is all I have to say: I cannot add much more. I personally cannot give any explanation as to why fibromyalgia is not seen as a long-term illness. I have taken a lot of notes on the contributions of the Deputies who spoke with passion about this debilitating disease. I myself know people who have fibromyalgia and it is a debilitating disease. I will bring the Deputies' concerns and views to the Minister and ask him to reply to Deputy Gino Kenny directly regarding the meeting.

Deputy Gino Kenny: Information on Gino Kenny Zoom on Gino Kenny On a point of order, we are making statements rather than discussing the motion I have in my hand, but I request that the Minister of State ask her colleagues in Government to take up this motion and table it themselves. They may choose to modify it, but it really goes to the crux of the matter we have been discussing. I appeal to the Minister of State to bring the motion back to her colleagues so that Government can table it and so that we can get consensus on this issue.

Deputy Catherine Byrne: Information on Catherine Byrne Zoom on Catherine Byrne I will talk to my colleagues about it.

Saincheisteanna Tráthúla - Topical Issue Debate

Childcare Services

Deputy John McGuinness: Information on John McGuinness Zoom on John McGuinness I bring to the attention of the Minister the crisis in the not-for-profit community childcare sector. She will be aware of this issue because I have forwarded her considerable correspondence from the groups concerned not only in Carlow-Kilkenny, but also in the neighbouring counties. In addition, there is an issue in respect of Pobal investigations into childcare and audits which have taken place, but also with investigations into community care units throughout the country. Public meetings are being held. The Minister of State, Deputy Phelan, who sits at the Minister's side, attended one such meeting. The critical need for finance and funding in this area and the need for an understanding of how these services are delivered were outlined for us at this meeting. These are the most marginalised communities in the country. A childcare facility in one community has told me that it will not be able to re-register 49 children because of what Pobal said in a recent audit.

It is also true that these facilities are dealing with parents and families, some of which are dysfunctional and some of which have great difficulties. As a result of that, children may arrive late or go home early. The centre, which is usually a family resource centre, has to engage with the families and has to encourage them along the route to childcare and after-school services. That has be understood. The system must be flexible if it is to allow all of the services to be delivered. If numbers are lost in the not-for-profit sector, staff will then be lost. The sector is currently losing staff because much better pay is available in the private sector than in the not-for-profit community sector. Despite this, those in the not-for-profit sector are doing an extremely good job. They are certainly having a positive impact on the communities they serve.

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