Dr. Rónán Collins:

I accept that is the Deputy's impression. I have only been in this job for a couple of months. To date, there have been informal discussions but there will be fairly focused meetings between now and June about where we fit into the neurorehabilitation strategy. There are elements of the national care programme for older people that fit into this as well. Indeed, the three programmes need to have a discussion because neurorehabilitation is not just a specific entity on its own. It is a model of care that transcends several different care programmes. A pretty intensive level of work will be done on this over the next couple of months.

Deputy O'Reilly is right to point out the importance of ensuring that more people do not survive stroke at the expense of disability. The mortality figures have dropped from 19% in 2008 to 12% now, which is a huge shift in the stroke survival rates. We have made a lot of progress in that regard. Our nursing home figures have stayed relatively stable over the past three years. They stood at approximately 15.2% in 2015 and are now around 15.9%. They are running a little bit in the wrong direction but people must understand that we are going to have an increase in absolute numbers in the next couple of years. There will be regional variations on which I cannot give answers to the Deputy because I do not have the data here. Some of it can be home-care package dependent, in terms of whether people can get home in certain circumstances. Those admitted to nursing homes tend be people in the moderate to severe disability category but I can assure the Deputy that we are watching it closely. One of our key performance indicators is whether people are being discharged home. Next year we plan to use an indicator of disability as a publishable criteria in our stroke register. We are going to start using the modified rank and scale as an analysis going forward so that the level of disability after stroke will be clearly visible. Up until now, it has been a surrogate in terms of going home or going to a nursing home, as I am sure the Deputy appreciates.