Failure to develop specific health policies to manage diabetes care has led the HSE to spend over €239 million on in-patient costs treating largely preventable complications of diabetic foot disease between 2005 and 2009, according to Diabetes Action’s “Half the Services, Half the Care” advocacy and awareness campaign.
Diabetes Action, a newly founded advocacy group, launched its national “Half the Services, Half the Care” campaign today in a bid to influence government health policy which it says is failing to provide targeted services and care for Ireland’s growing diabetes community.
“As a result of undiagnosed and poorly controlled Type 2 diabetes people are needlessly developing foot complications, like ulcers, which too often lead to lower-limb amputations. Between 2005 and 2009 1,579 people with diabetes in Ireland underwent a below knee amputation and nearly 6,000 people with diabetes developed a foot ulcer requiring in-patient treatment”, said Dr. Ronan Canavan, Consultant Endocrinologist at St. Vincent’s Hospital.
With the lowest level of manpower in podiatry in Europe, Irish people with poorly controlled diabetes are uniquely vulnerable to developing preventable foot complications which can lead to amputation and lower limb-loss. There is no system in place to identifying or track at-risk people to ensure preventative measures are taken to stop diabetic foot complications before they can develop.
“Half the Services, Half the Care” is calling for 20 podiatrist positions nationally to work with people with diabetes and provide a national screening programme – the annual cost of these positions is just €1.56 million. The service would pay for itself on the basis of each podiatrist preventing only three in-patient foot ulcers treatments each year.
“The cost of treating diabetic foot disease in Irish hospitals is staggering. €239 million only covers the direct in-patient hospital costs – it doesn’t take account of the cost of dressings, antibiotics or social welfare - to say nothing of the personal costs of periods of immobility or loss of earnings. Our figures also indicate that close to 50% of people with diabetes who undergo a lower-limb amputation are of working age” according to Dr. Canavan.
“The HSE is not channelling the financial and human resources in the health system effectively to tackle diabetes. This year €580 million or 5% of the national health budget will be spent on diabetes care; 60% of that figure will be spent on treating preventable complications. A National Strategy for Diabetes would dramatically reduce inpatient costs and result in better health outcomes for people with diabetes” he concluded.
Dr. Canavan said that the HSE’s Audit Report on Diabetes, published this week, recorded a significant decrease in the prevalence of foot ulcers for patients with both Type 1 and Type 2 diabetes (2.5 % in 2009 compared with 6.1% in 2003). This improvement can be attributed to the implementation of an evidence based foot care protocol and increased numbers of patients having a regular foot assessment and review by a podiatrist.
“Half the Services, Half the Care” is calling for HSE resources to be redirected to provide a cost effective national foot screening programme which would identify people with an at-risk-foot. An annual check-up for people with Type 2 diabetes could reduce the cost of treating diabetic foot conditions by as much as 50% and potentially save the HSE over €115 million over a 5 year period.
Diabetes Action also launched its web-site
http://www.diabetesaction.ie. The web-site is a targeted campaigning tool for the public to use during the two-year “Half the Services, Half the Care” advocacy initiative. DiabetesAction.ie allows people to contact their local politicians about local, regional and national health services which affect people with diabetes and asks politicians to lobby the HSE to develop and implement a National Diabetes Strategy
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