Mr. Chris Macey:

I will answer that before handing over to Ms Reilly. We have had a cardiac services review on acute hospital services around heart disease. The four stages are prevention, pre-emption, crisis and post-crisis. There is no holistic approach to policy around cardiovascular disease. As our statements pointed out, that is putting services in limbo and it prevents workforce planning and the people responsible for running services from planning and delivering them in a coherent way.

Likewise, with the national stroke strategy, bits of money have been found for it. There is an implementation plan, but it has not been rolled out in the way it was supposed to have been. A small number of posts have been filled, but many posts that should have been filled have not been. Every year, there is no money and then there is a bit of money but no coherent and consistent approach. Services need to be rolled out.

We were disappointed when the national stroke strategy came out because it is very focused on acute care. There is not much on life after stroke, which is a huge area of unmet need in Ireland. We made those views very clear at the time. Even in the limited form in which it was delivered, it is not being implemented.

The unmet need is growing all the time.