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Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Seán Crowe: ...to be in attendance. From the Multiple Sclerosis Society of Ireland I welcome Ms Alison Cotter, research and advocacy officer; and Ms Richelle Flanagan, patient advocate. I remind witnesses of the long-standing parliamentary practice that you should not criticise or make charges against any person or entity, by name or in such a way as to make him, her, or it identifiable, or...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

.... Community neurorehabilitation teams represent one of three key deliverables from the national neurorehabilitation strategy. The other two key commitments from the strategy are the delivery of long-term community neurorehabilitation services and inpatient neurorehabilitation beds. We need further investment to support the delivery of longer-term community neurorehabilitation services...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

...to patients and clinicians on the ground who would be aware of this issue and of the travel and stress involved for people. As the Senator says, if it is a choice between having a patient travel a long journey for regular care, that of course has to come into the clinician's decision. Again, I am not speaking for neurologists or the neurology clinical programme, but it makes sense that...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

...nurses, a fifth of what is required. As I said, headache is an issue that needs to be investigated in order to rule out serious causes and there is also the issue of the maintenance of people with long-term migraine. We should have 37 headache nurses, but we have just nine. We should have 37 epilepsy nurses, and we have just 26. The commitment to 21 nurses was given in view of that...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Róisín Shortall: .... The recommendation for 100 comes from the model of care, is that right? Yes. Twenty-one were recommended and funded in budget 2022. We are now in the middle of 2024. Those posts were funded long before the recruitment embargo. How did they get caught up in the recruitment embargo? Why were the posts not filled? Was there a particular reason? Will the witnesses talk about that?

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: We had a long dialogue on the neurorehabilitation strategy. Deputy Shortall has been extremely supportive. She has a long memory for some of the issues we highlighted. We came to the committee at a point four or five years ago when the neurorehabilitation strategy group was not meeting and there was a lack of energy and drive. We are happy to say that has...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Neasa Hourigan: .... We had all thought we were moving forward and it seems now that we have delayed. It is worth contextualising that the teams that are already existing are only at 30% and 60% of staffing. How long have those teams been in place? Has it been more than a decade?

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Neasa Hourigan: ...putting those teams in place more than a decade ago - at the last session we talked about how this is not about capital investment or accommodation necessarily, but rather hours and staffing - how long does Ms Rogers expect the kind of transition period for getting the next four up and running to take? I ask Ms Rogers to outline a timeline.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

..., they cannot cough it up because their muscles are not working properly. This is where it is really important to get intervention by a speech therapist to keep those muscles strong for as long as possible to prevent people getting an infection, it going down into their lungs and them ending up in hospital. We know from the services in Holland that physiotherapist intervention has been...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Bernard Durkan: ...are all vital services. I have also no doubt that there are some services which got a response in line with their expectations and others which did not, but it is the patients who suffer in the long run, and in the short term sometimes as well. If Ms Rogers were to tell us now the most important thing from her point of view, we will highlight this and pursue it. I realise not everybody...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: We were over the first hurdle in that after a long time of underinvestment in neurological care, we saw significant investment in the community neurorehabilitation teams in the past two successive budgets in acknowledgement of the Minister of State with responsibility for disability there. We saw that funding for 21 specialist nurses at one go and we saw the funding for...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Frances Black: ...I hope that Ms Flanagan might be able to provide some insight into her personal experience of those living with neurological conditions. Perhaps she could speak specifically about the impact of long waiting lists and service gaps on individuals with neurological conditions and their family members. As a family member of somebody who has a neurological issue, I know the kind of anxiety...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

...have an expertise in understanding the synthesis between the neurological condition and, as Ms Flanagan has said, what is due to the condition and what is due to a very normal reaction to having a long-term neurological condition. Neuropsychologists understand the interplay. It is a very rare expertise in Ireland and very hard to access at the moment. Again, we need community...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

..., nor should it be. What we voluntary sector providers do is enable people to maintain the gains beyond that, continue that improvement and enhance the effectiveness of that investment. Providing long-term specialist neurorehabilitation services in the community is so important in delivering the national neurorehabilitation strategy. We need to see proper investment year on year in...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

...those gains. There is currently a post-rehabilitation void. People may go home and may lose the gains they had which makes that investment null and void. These services pay for themselves in the long run. Research has shown that delaying or reducing disability due to MS reduces costs to the Irish health system by €19 million a year. I will also note, as Deputy Conway-Walsh has...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

...a community neurorehabilitation team, is limited. They still have a lifetime with these conditions and that is where the services provided by our organisations come in. They are already providing long-term community neurorehabilitation services in every community throughout Ireland and it is very important that they are seen as part of the neurorehabilitation strategy and that this...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

John Lahart: ...not in a haughty way. I am not getting carried away. It has allowed me to see the little gains you can make as a backbencher when you take an interest in a particular field. I accept there is a long way to go.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: Bloomfield is a member of the Neurological Alliance of Ireland. We acknowledge its work. Again, it is the bedrock of community, the long-term community piece, that the voluntary sector provides.