On three occasions in 2022, I raised the issue of the pain clinic at Sligo University Hospital, SUH, with the Tánaiste and the Minister for Health, when there were two service interruptions and, previously, when it was closed during the Covid period. Those issues were resolved and the service resumed. However, just over four weeks ago, I received information that there was to be a reduction in service at the pain clinic, with fewer consultants providing the service. I put down three questions to the Minister seeking information on the possible reduction in the number of consultants and a possible reduction in service. I have received no reply. This week, the news broke on local media that the pain clinic is to close tomorrow. Saolta University Health Care Group has since indicated that it will be a temporary closure. While I welcome that indication, I remain concerned.

When I submitted the three questions to which I referred, I also asked the Minister how it is proposed to alleviate the backlog of people waiting to access the pain clinic. I did receive a response to that question. It informed me that there are 341 patients on the SUH outpatient list and 107 on the inpatient list. Before there was any talk of closing the service, there were 448 people on a waiting list to access it. Many of the patients currently accessing the service are really concerned by the prospect of its closure, even if it is only temporary. The service is their lifeline. Chronic pain is often invisible. People who suffer from it feel very isolated. On average, it takes four years from initially visiting a GP to seeing a consultant and getting a diagnosis. Then people have to go on a waiting list to access the service. They are very worried that the service they rely on, which they cannot avail of anywhere else, could be pulled.

I have several questions for the Tánaiste. First, what alternative arrangements are being put in place for the people currently accessing the service? Will they be able to see their current consultant? Has the passing over of records and so on been sorted? Second, what will be done about the people on the waiting list? Have they received any communication about what will happen next and where they will go? Third, why did Saolta University Health Care Group not provide for a continuum of service? It must have known some of the consultants were departing. We have been told consultants are being recruited but, as we know, recruitment can take, six, 12 or 18 months. We are being told the closure is temporary but people have seen the pain clinic closed previously. They have waited and waited for the service to resume. Once again, there was no notice given to patients.

The Deputy's time is up.

People are not interested in hearing about Saolta University Health Care Group being in the process of recruiting consultants.

I thank the Deputy for raising this issue. Chronic pain is a devastating condition because it is a long-term one. Thankfully, there has been significant development in provision over the past decade or so but it took a long time to get a proper base within our heath service more generally. The reason for the temporary closure of the chronic pain service in Sligo University Hospital is, as the Deputy said, that the two consultant doctors providing the service are moving to new roles. The HSE advises that recruitment to fill those posts is ongoing and everything is being done to minimise the impact on patients. The refilling of the posts is not impacted by any recruitment pause or anything like that.

As an interim measure until the new consultants are in post, alternative arrangements are being put in place for patients who are currently attending the service. These arrangements include appointments for procedures being offered at Kingsbridge Private Hospital, Sligo, and exploring outsourcing with the National Treatment Purchase Fund. In July, a locum consultant will commence overseeing the governance of a pain management education programme, which is a psychology-based rehabilitative treatment for people with persistent pain. We are committed to continuing to invest in Sligo University Hospital. Staffing at the hospital has grown by 379, from 1,677 in January 2020 to 2,056 in January this year. That is a 22.5% increase. Since 2022, this includes 50 more nurses and midwives, 33 new medical and dental staff, five more patient care staff and 13 additional health and social care professionals. The budget has gone from approximately €159 million in 2020 to €187 million, which is an increase of €28 million, or 17%, in just four years. A total of 27 new beds have opened.

The National Treatment Purchase Fund has advised the Department of Health that three pain relief insourcing initiatives have been approved for the Saolta University Health Care Group, two for outpatients and one for inpatients, which will facilitate treatment for 580 patients on pain relief waiting lists. There are 341 people on the Sligo University Hospital outpatient pain relief waiting list, 78% of whom are waiting six months or less. A total of 107 patients are on the hospital's inpatient day case pain relief waiting list, with 61% of them waiting less than six months. I am not aware of the background as to why the two consultants at SUH's pain clinic have left at the same time and moved on to different portfolios and whether those departures were expected. The Deputy makes a reasonable point that this situation should have been anticipated and that recruitment could have begun earlier to coincide with the consultants leaving.

The Tánaiste said progress has been made in the provision of pain relief services. I agree there has been some progress but it is important to note that there has been a change in the international classification of chronic pain. In moving from the tenth revision of the International Classification of Diseases, ICD-10, to ICD-11, chronic pain is now recognised as a disease in its own right as distinct from a symptom of another disease. The response in Ireland has been to put in place a pilot programme. That is all we have done. The Tánaiste says we have made progress but, in fact, this country is not a good place for those who suffer from chronic pain. The issue needs to move to the top of the agenda.

The Tánaiste is telling me that the Saolta group has various initiatives, is looking to recruit consultants and has approved this and approved that, but I can tell him that patients in chronic pain in Sligo, Leitrim and Donegal - because it covers that entire area - wait for long times to get access to a clinic. There have been many stoppages in the service and now, with no notice, it is gone. Yes, they are promised the closure is temporary but I want an absolute guarantee that this is the case.

As I said earlier, the locum will be appointed in July. Alternative arrangements include appointments being offered in Kingsbridge. The NTPF also has a number of schemes for the Saolta group that should also help in providing treatment to people. I do not disagree with Deputy Harkin's fundamental point about the importance of pain management. It has significant implications for patients and those in persistent pain or chronic pain. Over the last decade or so, it has moved on from when it was as an embryonic service. It has improved significantly. It is very unfortunate that two consultants would leave at the one time. Every effort must be made to accelerate the recruitment of permanent replacements for the two consultants who have left. In the meantime, we have the use of the locum system and also the funding through the NTPF.