Professor Orla Hardiman:

We need to be careful because it depends. If somebody has a neurological disability that is of concern, there are mechanisms and facilities for general practitioners to access neurological consultations pretty quickly. The waiting list is triaged. When a letter comes into a hospital, the letter is reviewed. If the referral suggests that this is a problem that needs to be investigated urgently, my colleagues and I will triage that to an urgent emergency consultation. It is not the case that somebody with a potentially very serious or life-threatening condition would wait for the four years for a consultation. Our general practitioner colleagues are very good at identifying such cases and would make the referral through the appropriate channels and patients will be seen more rapidly. It is important to say that. There are situations where it may not be an acute or life-threatening condition where a neurological opinion would be valuable and develop a care plan. In those instances, from the time of first symptom, depending on the symptom, the general practitioner will make a referral.

As I mentioned earlier, when we audited the types of referrals coming in, across the board in all the hubs we looked at, between 25% and 30% of those referrals were related to some kind of headache syndrome. In order to address that, we put together a pilot programme to try to reduce the waiting time for those people and maximise the benefit of the consultation. The headache and migraine programme funded through the Sláintecare pilot implementation programme was very successful and it will hopefully be rolled out. In the process of doing that, we used three hospitals. We undertook work in each hospital to understand the waiting lists better. Some hospitals, including in Galway, did a waiting list audit and were able to reduce a significant proportion of people on the waiting list by engaging with patients by telephone. The waiting lists are a useful measurement but they are not an ideal measurement.