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

It has been a great privilege and honour to hear the respective contributions of the delegates. It is the culmination of some work done by a small group of people. I thank the members of the committee who have been hugely supportive since the proposition to meet the delegates and hear what they had to say was first posed. I say this sincerely because Government and Opposition Members of both the Seanad and the Dáil are present in this small number. I thank all of them sincerely.

I heard a fine tribute to Mr. Quigley in the course of the contributions made earlier. Mr. Pat O'Rourke referred to him as the best in Europe. That has to apply to Mr. Quigley, his colleague and team at the Royal Victoria Hospital. I would have no other view and nobody should. It would be absolutely wonderful if this facility could be sited in the second city on the island. All of the reports have been hugely complimentary and encouraging.

I wish to put a number of questions from a layperson's position. At what point in the life passage of a person dealing with Parkinson's disease, essential tremor or dystonia is it deemed most appropriate for him or her to access deep brain stimulation? Perhaps we will focus on Parkinson's disease initially, as its greater prevalence means that it accounts for the greater number of those who would benefit most from deep brain stimulation. Is there a profile of who is the most suitable? I address that question not only to Mr. Quigley but also to the other panellists. The Chairman will ask each of them to respond at the end. Can they give us a sense of whether there is a particular point in the life experience of someone dealing and coping with Parkinson's disease at which deep brain stimulation becomes most appropriate?

I would like to ask about the costs and savings in the health budget. It was suggested a saving of some 20% in the cost of the procedure would result if it were located here on the island of Ireland, as against having to access it overseas. The NHS is applicable in the Six-Counties on the north of the island. In that sense, I presume it is open to all patients. Perhaps Dr. Walsh and Mr. O'Rourke might tell us what the position is here. Is it covered for medical card holders under the terms of the HSE? Will they profile those domiciled in the State who can access deep brain stimulation? Is it a private commitment only that is covered, or is it covered under the general medical services scheme? Is that another complication we would have to address?

Ms Tufts has highlighted that if this happens, not only will there be a saving in the health budget but there will also have to be significant savings for individuals and families. This aspect of the matter has come across in each of the contributions made. Would any of the panel like to comment further on this aspect?

I would like to return to the question of the number of people travelling to Britain from the North and the South. I want to get a sense of the number of people who are accessing deep brain stimulation outside the island of Ireland. Are there locations other than Britain providing deep brain stimulation services to people resident on the island of Ireland? If so, perhaps it is more likely that the people in question come from this part of the island than from the North. I am not sure if that is the case.

I would like to ask Mr. Quigley about the capacity of the Royal Victoria Hospital. What would he expect? Obviously, it stands unquestioned that there would be a greater take-up if the opportunity were to be provided here on the island of Ireland when it would become much more affordable. What does he expect the potential annual throughput would be? What level does he expect the hospital to cope with in the initial period and over a period of years? How soon could we expect this proposal to come to fruition and be delivered on? How quickly could we move on it? Dr. Tony O'Connell, the national director of acute hospital services, and the assistant national director have apologised for being unable to attend this meeting. Unfortunately, they are both at another location in this institution this morning. We were hoping they would be with us, but all of the indications from a HSE perspective are very positive, which is very encouraging. Do the delegates have any sense or idea of how quickly this proposal could come to pass?

Would it be possible for Dr. Walsh to expand on the point made on greater male prevalence? Why is the prevalence of Parkinsonism greater among males than among females? Will Dr. Walsh indicate what percentage of those with Parkinsonism are males and what percentage are females?

I heard the points made about opening other locations on the island of Ireland in the medium to longer term. Initially, the critical point is to have the service started. The Royal Victoria Hospital is prepared and ready and clearly has the support of its professional counterparts throughout the island of Ireland. I look forward to hearing the further contributions of Dr. O'Connell, engaging with the committee and encouraging the Minister, the Department of Health and the HSE to engage at the earliest opportunity with their counterparts north of the Border.

I was taken by the recent decisions of the new Minister for Health on the provision of cardiac services for children north of the Border. More and more, people are thinking on an all-island basis when responding to the health needs of the people for whom this island is home. That is a very wise step for all of us to take. I hope that, in this instance, we can provide a further example of the benefits of such an approach that can accrue for each and every one of us.

I would like to conclude by reiterating that Ms Tufts has made a wonderful contribution to the meeting. I thank her and her husband, Christopher, for joining us. I know that it was suggested she was going to make a little demonstration. I do not know whether she would like to do so, but we will leave it to her to make that call. Perhaps the Chairman might invite her to do so at some point. I again thank Mr. Quigley, Ms Moore, Mr. O'Rourke, Dr. Walsh and Ms Tufts.