Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I thank the delegations not just for their presentations but their work in the preparation of these submissions. This is an important area of health care and I welcome the fact we are addressing it once again.

Ms Magdalen Rogers set out clearly the significant shortcomings in the provision of neurological care, including long waiting lists for access to specialists, inadequate access to multidisciplinary teams, lack of community after care and neurorehabilitation. Professor Orla Hardiman made the point about a largely disjointed non-co-ordinated approach which is costly and ineffective. Reference was also made to the recruitment embargo in the public sector putting pressure on therapy services. This is a policy that the committee has not overlooked. We need to get the message through that it cannot continue because it is having serious detrimental impacts on treatment programmes and outcomes.

I have previously highlighted the inadequacies of neurorehabilitation services with the Minister for Health at the committee’s July quarterly ministerial meeting. The response I received was wholly inadequate and was deeply disappointing. I commend the launch of the alliance’s neurorehabilitation manifesto last year and hope it continues to have good luck in all it undertakes. Its latest survey on the numbers suffering neurological conditions demonstrates a point the committee has addressed repeatedly, namely 27% of them have had medical cards refused or withdrawn. This is further evidence of a point we have argued consistently with the Minister and the HSE executive at this committee. In fairness, it is not just Opposition Members on the committee who have raised this matter. We are all universally angered by this fact and have asked for changes to the policy.

I thank Professor Hardiman for providing us with a transcript of the telephone conversation between a patient and the medical card centre. All Deputies and Senators would have similar exposure. I note she identified the lack of joined-up thinking and asked how we can discharge people to community-based services that do not exist. While the number of neurological consultants has increased from 11 in 1996 to 34 now, this has only uncovered a significant unmet need. What is the proper complement of consultants to address needs adequately and in line with European norms?

I thank Dr. Doherty for his review of epilepsy services. He stated managed primary care will be delivered by general practitioners working with practice nurses and with the guidance of epilepsy advanced nurse practitioners, ANP, in every region. Are such ANPs in place in every region? He also referred to contractual issues that need to be resolved before widespread uptake in primary care.

Are these contractual issues with the Irish Medical Organisation, IMO, and how near are they to a resolution? It is very worrying that Mr. Lawless said the NECP and HSE have provided funding for seven nursing staff to deliver the epilepsy programme in the HSE south but for unclear reasons nothing has happened and, as a result, over €500,000 worth of equipment is lying idle. Who bears direct responsibility for this shocking exposure of the failure properly to provide and see the utilisation of expensive and important equipment? Who should make the appointments that have not been made?

I sincerely thank Mr. Lawless for his presentation. It has been some years but this is my first opportunity to offer him my sincere sympathy on the loss of his dear wife back in 2005, as he indicated in his presentation. I very much welcome what Mr. Lawless has presented to us. It is a significant piece of work. He has made several recommendations, some simple, some more complex. We should send Mr. Lawless's presentation to each of the various entities, such as Beaumont Hospital, the HSE or HIQA, and ask them to respond. I hope that would be in some way a useful employment of the work and effort he put into preparing his submission to us. It is deeply appreciated.