Ms Magdalen Rogers:

I thank the Deputy for raising this issue. I am very conscious of the demands on the committee but I strongly recommend that it hold specific hearings or consultations on the issue of the national neuro-rehabilitation strategy, to include, if possible, access to neuro-rehabilitation services for children, which is not included in the national neuro-rehabilitation strategy but is also a critical issue. I highlight the serious concerns of the Neurological Alliance of Ireland in respect of the fact that, as the Deputy stated, a strategy is in place. The implementation plan for the strategy was published in 2019. It was a three-year implementation framework that ended in December 2021. There has been a dismal lack of progress in terms of putting in place hospital-based inpatient beds and also in developing community neuro-rehabilitation teams. Deputy Cullinane raised this issue earlier.

We have an added concern in respect of the neuro-rehabilitation strategy following on from the Covid-19 pandemic because we believe there is a hidden impact of Covid on access to neuro-rehabilitation services. Because teams are not in place, there are no waiting lists for those teams. No one is reporting waiting lists for those community neuro-rehabilitation teams. We are aware there was a significant amount of closure and curtailment due to staff redeployment in the community for access to the neuro-rehabilitation that there is in place. That has increased since the pandemic. There are people who are cocooning or deconditioning, as well as those who were discharged early from acute hospitals for their own safety. There were no community neuro-rehabilitation services in place to discharge them to, so they effectively missed out on a period of rehabilitation. There is an entire backlog of care through the past two years. On top of that, members of the Neurological Alliance of Ireland have reported that there are people with symptoms of long Covid trying to access their services. There is a perfect storm in the context of neuro-rehabilitation services and, matched with that, a strategy that is not working. It is not being implemented on the ground.