I have raised the issue of diabetes care many times in the House. Despite that not much investment is needed, diabetes treatment seems to be left idle. We spend €1.3 billion per year on diabetes treatment, €800 million of which is spent on treating the complications of the illness. This €800 million could be significantly reduced with proper management of diabetes care. It is not often that savings can clearly be made in health spending. Proper care of diabetes is one of these opportunities.

In Donegal, of 666 adults with type 1 diabetes, only 20 attending Letterkenny University Hospital have access to an insulin pump. This week, I received a letter from a constituent who, after living with diabetes since he was eight years old, was approved for a pump. However, Sligo University Hospital is the only place adults from Donegal can have a pump fitted. Letterkenny University Hospital does not have staff to fit pumps. My constituent was delighted to get a quick appointment for Sligo hospital and even more when he was told his pump would be fitted before the end of January this year. Given that he was due to start a new job in Scotland on 1 March, the timing could not have been better. However, ten days ago he received a call from Sligo telling him the diabetes nurses' hours had been cut by 15 hours per week and that they could not now fit his pump. There are seven insulin pumps in Sligo that will not be fitted and that are gathering dust at a cost of €4,700 each. In his letter, he said:

I can go to Dublin and have a pump fitted privately, but I won't, and it's not because of the money. I should not even have to go to Sligo. These services should be provided here in our local hospitals where they have all our history and the staff know us. I have now lost a great career opportunity in Scotland because of this, as I need the security of the insulin and the blood glucose sensor before starting my job and this opportunity is now gone.

As the Tánaiste knows, there is little hope of this man getting a job in Donegal. The Government has made many claims that health spending is at record levels.

No doubt the Tánaiste will quote that back to me in response to this question. Despite this, we see the hours of diabetes nurses in Sligo University Hospital being cut, meaning that insulin pumps that would save the health services money are not being fitted and, due to staffing shortages, the pumps cannot be fitted in Letterkenny University Hospital either.

What will the Tánaiste say to Ciaran, the writer of that letter, and to the six other patients who have not had their pumps fitted? Why is it, when savings can clearly be made in the health service through proper management of diabetes care, the Government will not make the resources available to ensure the proper management of this disease?

I will ask the Minister for Health to communicate directly with the Deputy on this situation in Donegal around patients who have diabetes. The Minister will be able to give a detailed reply on the particular local issues in Donegal and Sligo for those cases highlighted by Deputy Pringle today.

The goal is to provide high quality service to patients, such as those the Deputy has described, in their own homes or with local services and local GPs where possible, as opposed to having to travel farther to get those services. The Government has made a commitment to ensure those services are available and this is reflected in the highest health budget that has ever been agreed, at €14.6 billion. This demonstrates the Government's commitment to ensure patients, such as those described by Deputy Pringle, will have those services available to them.

There are issues around recruitment. The Deputy highlighted the subject of the nurses in the area and every effort is being made to recruit more nurses. The initiatives being undertaken by the Minister, such as the bed capacity review which is under way, the increased budget, the new GP contract and the recruitment campaign, are to make sure we have the kind of local health services that are needed. We also have the all-party committee working on the ten-year plan for the health services and this is due to be received in April this year. Additional funding of €18.5 million has been given to primary care centres, including enabling the support of various paediatric cases and the type of situation for specialist intervention that is needed for diabetes. Clearly, every effort has been made to make sure services are available locally for specialist conditions such as diabetes. The new GP contract will ensure there is an even more flexible service available to people in local areas and given by GPs.

I will ask the Minister for Health to liaise directly with the Deputy on the situation in Donegal, but with regard to the overall approach to development and making sure people have the very best health services, I have outlined to the Deputy the various initiatives the Minister is taking to arrive at that situation. There is ever-increasing demand on our health services, as the Deputy knows, but equally there has been an ever-increasing budget to meet that demand.

I welcome that the Minister will make contact with regard to the local issues, but that is only part of the problem. The Tánaiste has outlined the record spending, and I anticipated this response to my question. The issue, however, is not about staff in Sligo University Hospital but about the hours of the staff being cut. It is not a recruitment issue but rather bad management, bad planning and complete neglect by the Government and the HSE in dealing with these issues. Installing the pumps for patients will save money. It is clearly outlined. Some €800 million per year is spent on dealing with problems from lack of treatment and lack of management. All these problems can be prevented by proper management and treatment. This is what is necessary for people. The Tánaiste's response about the record levels of spending will ring hollow to those who are without diabetes pumps. They rely on the pumps, which means they do not have the security to be able to get a job when they are without the pumps.

In 2017, there will be 11 children in Letterkenny University Hospital who will transition into adult services for diabetes care. There is a waiting list of 21 months for an appointment to see a consultant. This is unacceptable. All the Tánaiste's talk of extra funding makes no difference to those people's lives.

The Minister for Health is also taking an initiative with the National Treatment Purchase Fund to ensure waiting lists can be dealt with more effectively than at present.

It is an extra initiative to ensure that patients' needs are responded to. While I do not have the details, I will ask the Minister to link with the Deputy. Clearly, the focus is on recruitment and there has been a change in regard to trying to recruit more staff on permanent contracts as opposed to agency staff. That may account for the situation the Deputy has described concerning nurses in the local area. I will ask the Minister to come back to the Deputy about that change in regard to the nurses because I do not have the details.

I want to assure the Deputy that the focus is on recruiting permanent full-time nurses who will be in a position to deliver the kind of services he has outlined. Every action is being taken. It is an international problem in terms of trying to recruit and retain nursing staff. The Minister has taken every action possible and has shown as much flexibility as he can in the context of ensuring that we can recruit new nurses.