€9.72m spent locally treating preventable diabetes foot condition

One podiatrist in Carlow Kilkenny to cover all footcare needs

324 hospital admissions for diabetic foot disease in the Kilkenny area have cost the HSE South €9.72 million.
Failure to develop specific health policies to manage diabetes care has led the HSE South to spend over €75 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 this week 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, Dublin. There is currently only one podiatrist working to cover the entire population the Carlow-Kilkenny area.
Of the 324 patients admitted to hospital with diabetic foot problems from Kilkenny, 72 were of working age. The Diabetes Community sees the development of diabetes podiatry services as a key and immediate priority in a National Diabetes Service Framework. The HSE report recommends the creation of 20 full time podiatrists (one per hospital diabetes centre nationwide). Yet nothing is being done to implement this recommendation.
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.
Dr Canavan stated, “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 ulcer treatments each year.
“We also would like 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 five-year period.

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