Dr. Niall Pender:

It is exactly that. For example, in Beaumont we cover a huge catchment area and, as a neuropsychologist, we are still holding a lot of people in my department who have nowhere to go after their injury and who suffer from cognitive difficulties, emotional difficulties, behavioural problems and relationship difficulties. There is nowhere to go. There is a huge challenge and Deputy Hourigan is absolutely right. CHO 9 covers a huge area of people and a wide range of people. We have enormous numbers of people with potential brain injuries of different types. We have a higher catchment area with higher rates of neurodegenerative disease, higher rates of injuries and different types of brain injuries. There is enormous complexity in CHO 9 because of the population we have which is a very fast-growing one.

There will be challenges no doubt, but we have good acute services and some nurses in place. We have acquired brain injury, ABI, teams and we have voluntary organisations, so we have a good infrastructure but we just need the team to be set up and we need that place for people to be referred to. People are still being referred into a void at the moment. One of the things patients themselves always experience is that they are hidden. There is very little voice for people with neurological problems because they do not know how to approach it, who to go to or where to go. GPs in the area may not know where to send people. Some people might be lucky and get access to physiotherapy or speech therapy somewhere. It really is a lottery and some people say they would be better off to be in other parts of the country because there is nowhere else for them to go.

Primary care services are trying to hold people together and to provide the best service but we need specialist units and people who know what they are doing. They are much efficient, patients get a much better service and the outcomes are much better. CHO 9 will be a challenge but there are good services there. We have the infrastructure and the broad scaffolding and the bones of it but we need better services.