There is widespread public concern among parents about what a local mother described as the “lack of real commitment and adequate care” of HSE for children with diabetes at Mullingar Regional Hospital.
Earlier this month, the parents of 130 children in the hospital’s pediatric diabetes department received a letter from the pediatric advisor, Professor Michael O’Grady, regrettably informing them that all appointments for pediatric diabetes clinics would be canceled “due to the continuing uncertain workforce.” “with immediate effect”.
Prof. O’Grady also complained that the unit as a whole would be threatened if enough staff were not available by the summer.
In response to a question from local TD Joe Flaherty, the Department of Health’s Secretary of State Mary Butler told the Dáil that a candidate had been offered the position of pediatric diabetic nurse and that he would start work in the coming weeks.
Given the lengthy HSE recruiting process, the national shortage of Clinical Nurse Specialists (CNSp), and the fact that Mullingar Regional Hospital has been without a CNSp for 14 months despite concentrated efforts to recruit one, these comments have raised more questions than answers for lots.
Statements by the HSE that resources will be provided have done little to allay fears from local mother Siobhán Beatty, who said the HSE must inform parents of what permanent resources will be in place when the service reopens that “the time has passed because half measures have been taken”.
“How is it possible that the hospital advertised, interviewed and offered the position within five days?” She asked.
“HSE recruiting campaigns typically last an average of six months. The consultant, Dr. O’Grady is not aware of any recruiting efforts and should be included in the recruitment process.
“We parents did not have direct communication from the hospital, the service advisor has not received any further information about what is promised, and we’ve basically heard everything before,” she said.
“This is a serious problem as HSE and hospital management have undoubtedly failed our children in their duty of care and have been failing for a long time.”
Ms. Beatty has been attending the clinic with her daughter Emma since she was diagnosed at the age of nine last January.
“I couldn’t speak highly enough about Dr. O’Grady who, in very difficult circumstances, did his best to make sure we received the education and information we needed to understand and treat our daughter’s type 1 diabetes” she said the Longford Leader.
Treating diabetes in children and adolescents requires a multidisciplinary team consisting of one Clinical Nurse Specialist (CNSp) for every 70 patients (or one for every 50 patients with pumps), a full-time nutritionist for every 150 to 200 patients, social workers and psychologists.
The Pediatric Diabetes Department at Mullingar Regional Hospital currently supports 130 children and adolescents, 41 of whom are receiving insulin pumps.
Based on these numbers, the device should have two full-time CNSp and special dietary support for diabetes in the region of 25 to 33 hours per week.
Currently, the service has no CNSp, no dietary support for diabetes of just three hours a week, no social work, and no psychological support.
“Although efforts have been made to hire a nurse, the specifications of the job are very tight and require both diabetic and pediatric specialties,” said Ms. Beatty.
“While a nurse is promised for 2022, we have the prospect of not having a nurse at all for the whole of 2021, as we have been without one for more than a year due to the generosity of Prof. O’Grady. ”
The pediatric diabetes CNSp for the division retired in May 2019. Although she was partially insured until November 2019, there has been no special diabetes care support in the department for 14 months.
There is a national shortage of individuals trained to work as CNSp in pediatric diabetes, where candidates must have a pediatric background.
Back in June 2019, Prof. O’Brady asked the HSE to remove the pediatric background requirements in order to expand the field of potential applicants to nurses trained in diabetes management.
However, his requests were ignored and when the position was first advertised in 2019 there were no eligible applicants. While Prof. O’Gorman was keen to reapply for the position immediately, the HSE Recruiting Service recommends at least six months between campaigns, and it wasn’t until September 2020 that the position was reapplied.
However, a successful candidate for the position may not take up regular employment until next year.
“Due to the ongoing lack of a multidisciplinary team, the future of children’s diabetes services in Mullingar is now seriously threatened and could potentially end permanently in the coming months,” said a concerned Prof. O’Grady.
“All children’s diabetes clinic appointments visiting Mullingar Hospital for treatment will now be canceled with immediate effect and will not be resumed until appropriate multidisciplinary team resources are in place.”
As a result of these closings and cancellations, parents have desperately turned to their local politicians for assistance in providing “basic life-saving resources” to diabetic children.
Should the service be permanently suspended, more than 130 patients will be referred to Dublin hospitals, which would likely overwhelm their services as well.
Longford’s mother, Lorraine Kelly, made the Longford Leader aware of her plight shortly after receiving the letter from Prof. O’Grady.
“That’s left to us. I’m angry, ”she told the Longford Leader. Her daughter Chanelle has been using the service for three years.
“What about our children? Where is the care for them? I am shocked that lets this happen because the care required for these children is vital. No more appointments, just when they get sick (we’re supposed to) take them to A&E. This is vital to the children’s health care and management. This is no joke. “
Another worried mother from Longford who does not want to be named has been attending the Mullingar Diabetic Clinic with her 13-year-old son since she was diagnosed with type 1 diabetes in December 2018.
“We live in Longford and visit this clinic every three months to make sure that my son’s diabetes is being treated and that it does not affect his life prospects as he grows and develops as he learns to live with his condition,” explained they.
“Prof. Michael O’Grady, the pediatrician consultant, has worked tirelessly with limited resources to ensure the continuation of the service to its 130 patients. However, since he can no longer guarantee the safety of his patients, he had to cancel all clinic appointments and no longer accept any new patients.
“Should this service close due to these insecure staffing issues, my child and the 129 other children visiting Mullingar will be referred to diabetic services at Crumlin, Temple Street or Tallaght hospitals.
“These services are already busy, and adding 130 patients to these services will definitely leave these hospital clinics overwhelmed.”
Parents of children who are patients in the unit have sent a letter to politicians reinforcing the HSE’s call for a solution to the problem.
TD Joe Flaherty of Longford / Westmeath has urged HSE to give an urgent notice when full diabetes clinic service will be available again to parents and children in Mullingar, stating: “It is very difficult for people and especially parents trying to dealing with medication, and treatment. It just can’t go on. “
