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Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Seán Crowe: We are meeting today with representatives from the Neurological Alliance of Ireland to discuss the impact of Covid-19 on neurological services, care and capacity. I welcome Ms Magdalen Rogers, the alliance's executive director, and Professor Orla Hardiman, national clinical lead for neurology and professor of neurology at Trinity College Dublin. All witnesses are reminded of the...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: We can certainly follow up on that. We will send on the information to the Deputy.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: It is very hard to tell without an effectively running implementation group for the strategy but, to our knowledge, there are three teams in place and up and running. That is not much different from the situation a decade ago when the strategy was first published.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: There are about half as many as there should be.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: Deputy Shortall raised the same issue earlier. The ultimate responsibility lies with the HSE, the Department, and directly with the Minister for Health who is responsible for delivering the strategy.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: We have had the appointment of migraine nurses.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: I thank the committee for giving us so much time.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: As I stated in response to Deputy Cullinane, it is estimated that we have half the specialist rehabilitation beds that are needed.

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: Exactly, Deputy. What we do not want to see is a further disenfrachisement of people with neurological conditions where only those who can pay can access specialist rehabilitation in the south. I am cognisant of the workload and number of issues that come before this committee but, once again, I ask the committee to do a special hearing on neuro-rehabilitation services...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: For a population of our size, 230 beds are needed. We have half that number. The majority of those beds, with a few exceptions, are concentrated in the National Rehabilitation Hospital in Dún Laoghaire. Under the three-year implementation plan and the national neuro-rehabilitation strategy, there was a commitment to have units of up to 20 inpatients and more than...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: If I could come in there briefly, I re-emphasise the need for the neuro-rehabilitation strategy to be implemented. Many issues are arising throughout the patient experience. For example, the Ombudsman report of last year, Wasted Lives, was an indication of the neuro-rehabilitation strategy not functioning in its implementation. People are ending up in nursing homes...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: Professor Hardiman can speak on this. The Neurological Alliance of Ireland is a member of the neuro-rehabilitation strategy implementation group, which recently recommenced meetings. The implementation group did not meet throughout 2021. As I explained earlier, there was a three-year framework from 2019 to 2021 to implement the strategy. I view the fact the...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: It is an issue for clarification as to where responsibility for it lives. Our understanding is that it comes under the women's health initiative. A strategy document was published on it recently by the Department of Health. What we need is clarity. Epilepsy Ireland as a member of the Neurological Alliance of Ireland has requested there be clarity on why only two of...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: It is a joint strategy of the HSE and the Department of Health. The ultimate responsibility needs to be for momentum to implement the strategy and call the meetings. There are all sorts of internal and systemic reasons, such as staffing changes, but they should not take away from the need or momentum to implement a three-year strategy. The Neurological Alliance of...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: I will need to come back specifically on these figures, if it is possible. To our knowledge, similar to the situation in neurology we have the lowest numbers in Europe for consultant staffing in rehabilitation medicine. This is something that has not radically changed over the decades since the neuro-rehabilitation strategy was published. The implementation of the...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: With regard to the neuro-rehabilitation strategy, we have not even got there yet. We have not even seen an attempt to recruit those multidisciplinary teams. As I explained earlier, there was a commitment in that three-year neuro-rehabilitation framework to have one community neuro-rehabilitation team in each CHO. That has not been progressed. As I said, the funding was...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: We have made many requests of the committee today but I have another one, which is that the committee holds a specific hearing on the very issue of the neuro-rehabilitation strategy. The lid needs to be lifted on the complexities involved in all of the false dawns and false starts in its implementation. We need to get a greater understanding of the impact of the...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: I agree with the Deputy that everything needs to be on the table and I will outline the concerns of the Neurological Alliance of Ireland. There is a strategy and how it gets implemented needs to be decided plus the implementation process needs to be effective. The strategy group needs to meet on a regular basis - we cannot have the situation again where it did not meet...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: We are very much focusing on neurology and neurology nurses, but I am very glad Deputy Cullinane has raised the issue of the neuro-rehabilitation strategy because it is something we in the Neurological Alliance of Ireland are extremely concerned about. The three-year implementation plan for the neuro-rehabilitation strategy was published in February 2019. That committed...

Joint Oireachtas Committee on Health: Impact of Covid-19 on Neurological Services, Care and Capacity: Neurological Alliance of Ireland (30 Mar 2022)

Ms Magdalen Rogers: There certainly is a capacity issue with specialist neuro-rehabilitation beds for the type of neuro-rehabilitation provided by the National Rehabilitation Hospital, for example. We estimate that we only have half of the specialist neuro-rehabilitation beds that we need in the country. The majority of them are located in the National Rehabilitation Hospital in Dún...