Séamus Healy (Tipperary South, Workers and Unemployed Action Group)

I thank the Irish Heart Foundation for the massive amount of work it has done in this area over the years by way of reports, research and proposals. Without its reports, there would have been much less progress in this area. We owe it a debt of gratitude for its work. As previous speakers noted, 10,000 people suffer from strokes every year in this country and as many as 2,000 die as a result. Approximately 50,000 people live with disabilities as a result of strokes.

This is an area in which prevention is better than cure. I welcome the progress that has been made over the past several years in this regard. I understand 16 hospitals now contain stroke units and the Government has announced that 90% of hospitals will contain units before the end of the year.

A report by the Irish Heart Foundation estimated the cost of stroke to be as high as €1 billion per annum. Approximately 40% of this amount is spent on nursing home accommodation. A significant proportion of this expenditure could be saved if acute services were made more widely available. The report also found that providing 95% access to stroke units could save 650 suffers from death or dependency each year. Achieving a 20% rate of thrombolysis could save a further 100 people from death or dependency. These are huge figures and they need to be taken on board by ensuring that a proper stroke service is in place throughout the country. The purpose of improving the Irish stroke service to acceptable international levels is not to save the Exchequer money but is to eliminate the catastrophic human cost of avoidable death and disability arising from stroke. Even today despite the improvement in services and the additional units I mentioned it is still to a certain extent hit and miss for stroke patients. Any Government will receive reports claiming that upgraded services would result in cost reductions at some stage in the future. The difference in this case is that better stroke services will lead to almost instant savings because the increased access to stroke and thrombolysis units will result in immediate improvements in outcomes. There would be immediate savings to the Exchequer and the State if the services are provided.

As other speakers have said, lifestyle, diet and exercise are obviously important. Other speakers have referred to the FAST - face, arms, speech and time - media campaign. I hope that campaign will be extended. I have heard there may be some difficulty with its funding and I hope the Minister will ensure ongoing funding will be made available for such a campaign, which has already been successful.

There is an absolute need for an integrated seamless stroke service, including rapid-access clinics, CT or MRI scanning and specialists for thrombolysis assessment. Ideally we would have dedicated teams in stroke units to provide care for stroke patients. Obviously those units should include medical, nursing and allied health professionals specialising in this area, which would ensure a major improvement in outcomes for patients who are threatened with stroke or who have a stroke event.

We need rehabilitation units as part of the service. These units need to be close to the patients as research has shown that support from families aids rehabilitation substantially. Obviously these units need to be properly resourced, staffed and funded. We need community-based services to ensure stroke patients can be brought back to their own homes and communities to recover and have a long life. I hope that the reductions in the home-help services as part of the HSE national health plan would be reversed because these home care packages must be available if the community-based services are to be effective. The service obviously needs to be fully funded and staffed with professionals with the expertise in the various areas to ensure a complete and holistic service is available from the beginning of the event through to rehabilitation and community care.

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