HSE ‘must boost resources’ to fight TB

RESPIRATORY healthcare professionals have called for an urgent review of national TB services following an outbreak of the disease in Cork.

The Irish Thoracic Society (ITS), which represents respiratory consultants, said it was time the Health Service Executive (HSE) invested in boosting resources to tackle TB at a time when 19 cases have been diagnosed in two Cork creches.

ITS president Dr JJ Gilmartin said: “The society is calling for the provision of the necessary resources to ensure that, what is essentially a preventable disease, is adequately controlled.

“These include adequate isolation and diagnostic facilities, increased public health and hospital-based resources such as specialist TB nurses and additional consultant respiratory physicians with expertise in the management of TB.”

At the moment, there are 32 respiratory consultants, and just four in HSE South, the lowest number of any HSE area in the country. Dr Gilmartin said the figures were “between 33%-50% too low nationally”.

He also criticised the shortage of pressurised rooms in acute hospitals to treat people with infectious diseases.

Dr Gilmartin said there was a need for greater integration of hospital, public health and occupational health services to prevent, diagnose and manage TB.

He said they were “particularly concerned at the Cork TB outbreak as it occurs in a vulnerable population of pre-school children” at a time where internationally, multi-drug-resistant (MDR) TB and extensive-drug-resistant (XDR) TB are on the increase, with a small number of such cases in Ireland.

Dr Gilmartin said concerns were heightened by the fact that both the Cork outbreak and the emergence of MDR and XDR cases “occur at a time when basic services required to prevent, diagnose and manage TB in children and adults are proving inadequate”.

“A case in point is the TB Diagnostic Laboratory in Cork which was forced to close earlier this year due to the poor standard of its facilities,” he said.

Dr Gilmartin said progress had also been slow in developing a national TB reference lab at St James Hospital in Dublin.

The development was promised when the de facto national TB hospital — Peamount — closed in 2004. The St James development will not be completed until mid to late 2008, the HSE said.

In Cork, a replacement lab will not be ready before the end of this year.

Dr Patrick Wall, professor of public health at University College Dublin, also criticised the lack of resources.

Dr Wall, who chaired a meeting in Cork on Monday where medical experts addressed the concerns of parents with children caught up in the TB outbreak, said a number of points had been raised, such as why adequate resources were not in place for screening, why parents faced delays getting chest X-rays for children and whether health screening of childcare workers should be introduced as the growth of creches continues.