Professor Orla Hardiman:

That is a really important comment about the relationship between the voluntary sector and the HSE-delivered services. There is a very close relationship there and we really need a better way of generating service-level agreements than what has been happening up to now. I completely agree with Deputy Cullinane on that.

I would also like to add a comment on rehabilitation. In order for a neurological service within the country to work effectively, we need neuro-rehabilitation teams within the community. We are very much committed to the Sláintecare model, but that does not take away from the fact that each of the centres for neurological care to which I referred earlier should also have a full complement of multidisciplinary services. Specialty services within the hospital sector are required in the acute interaction with patients and also in the chronic management of rare and complex diseases. There are some models of this working well between the hospital and the community, where there is an outreach service between the hospital rehabilitation service and the community service. That is a model we should be using. There is a massive need for community neuro-rehabilitation, but there is also an equal unmet need for hospital-based neuro-rehabilitation within the neurology hubs around the country. As the Neurological Alliance of Ireland survey demonstrates, that is seriously under-resourced at the present time.