Waiting list crisis: Four patients have died while on the diabetes waiting list in Beaumont Hospital, prompting the consultant in charge of the service to admit "the worry is we could have done something about it".
Dr Chris Thompson, a consultant endocrinologist, said the ending of a diabetes shared-care (DiSC) scheme with GPs in north Dublin had contributed to the waiting list for new diabetes patients in Beaumont rising to nearly two years.
"We just have no room for manoeuvre. My own role here has been looking after 4,800 diabetics.
"The EU recommendation is that each consultant looks after 1,000 patients. There have been a number of patients who have died while waiting to be seen and that always worries us."
Diabetes is a rapidly growing condition with 200,000 people in the State diagnosed and a further 200,000 unaware that they have the condition. Type II diabetes is associated with being overweight.
The DiSC scheme provided three check-ups per annum to more than 700 patients before its collapse last summer in a row over funding. These patients are now being referred to Beaumont, driving up the waiting list.
"To put it in perspective, the international recommendations are people with Type II should be seen a minimum of twice a year. Now we can only see them once a year. With the GPs, they were being seen about four times a year, which was about right," says Dr Thompson.
"Undoubtedly these patients now have a worse level of care. All the international standards would regard our 23-month waiting list as appallingly too long."
The issue is not confined to Beaumont. Diabetes services in all the major hospitals are under pressure.
Dr Thompson said he was used to a waiting list of three or four weeks when working as a consultant in Glasgow.
"I don't feel comfortable with this level of care that we are producing. We are at the limit with what we can do with current resources," he says. "I don't know if there is anything more the hospital can do. We have doubled the number of public clinics, we set up the GP care initiative, we have set up a number of specific clinics for adolescents. We have done everything managerially that we can do."
Medical staff and management at Beaumont are united in trying to alleviate the waiting list, but requests for additional funding this year have been turned down.
However, the hospital has raised more than €300,000 towards the cost of a new outpatients' suite for public diabetes patients.
For it to be effective, it also requires the appointment of a team of junior and ancillary staff to complement the appointment of a new consultant in the speciality.
"The current CEO of the hospital [ Liam Duffy] has been very supportive and proactive in trying to get us extra resources. And he has pushed for the provision of the new diabetes day centre and he sanctioned the appointment of the new consultant," said Dr Thompson.
He noted that an acknowledged shortfall in the number of consultants working with diabetics in Ireland was compounded by traditionally regarding diabetes and endocrinology as the same speciality.
"The official number of consultant diabetologists in Ireland actually overestimates the working commitment to diabetic patients because, in contrast to the situation in other European and North American countries, our guys are also expected to look after patients with thyroid disease, adrenal disease and pituitary disease.
"Although there is clearly inadequate numbers of consultant diabetologists in this country, the true shortfall is worse than might be suggested by the actual figures."
