John Dolan (Independent) | Oireachtas source

I am delighted that the six witnesses are before us. Their evidence challenges us in a number of ways. I look forward to reading the transcript. We may need to re-examine the issue. Much has been raised at this meeting that we cannot get into in this session alone - prevention, different service mixes, who provides what, impacts on lives, etc. I will leave that there, though.

I will start with Dr. McCarthy's presentation. She stated that 85% of the €1.9 billion for disability services was expended on residential day services and respite. Those types of services go back to old God's time when we did not have diagnostics, we tried to put people in caring places and we did not have much else going on. I would be interested in short responses to my question. Do we have the wrong ratios in disability services funding? While I am not suggesting that the services and supports receiving the 85% of funding are not needed, only 15% is being spent on supports that are located in the community even though it was pointed out that many people return to and try to survive in their communities. This is particularly the case for the cohort we are discussing today, namely, people with neurological conditions.

How might Sláintecare be part of the proposed solutions? Is it lacking in this regard or does it have potential?

I thank Ms Rogers for her presentation on behalf of the NAI. The national policy and strategy for neurological services was published in 2011 but the implementation plan relating to it was only published in February. What has been the loss of progress in those eight years of not having an implementation plan? Such a plan will never provide the billions required to address all of the issues but, in my view, producing strategies without timely implementation plans for the same year is wrong. A strategy or policy without an implementation plan is akin to providing pain relief. It is a three-card trick.

The impact of medicines was mentioned. One of our guests stated that, dating back over 20 years or so, there was not a lot in terms of medicines to give to people. I know from meeting people who suffer with MS that the lack of medicine in the early 80s made life pretty grim for them, which impacted greatly on their families. The same applies in regard to other neurological conditions. How has the development of medicines that can modify conditions impacted on people's daily lives and what is needed to further increase that impact?

I welcome the presentations on ARBI and FASD. Dr. McGonagle mentioned that identification of ARBI is poor and referenced data relating to Letterkenny, Sligo and Cavan. We hear a lot about continued waste in the health services. I am not too sure that when they speak about such waste, people are referring to the effects of misdiagnosis. Rather, they are speaking about items being thrown out or not used properly.

The recommendations put forward in the presentations are interesting in that they are not financial asks but calls for inquiries into what is being done for the thousands of people who suffer with conditions from which they are many knock-on effects, including for their families. The recommendations are a plea to us, as a committee, to do what we can to improve services in this area.