Ms Esther O'Shea:

Similar to the Deputy, I am a rural person as well but we will not have that conversation. I want to touch on the care pathways. Today, there are people being discharged from hospitals in Dublin, Cork, Kerry and Mayo. I am a cardiomyopathy patient living with heart failure and there are stroke patients, stroke survivors and people after myocardial infarctions, MIs, who have nowhere to go. They have no pathway and no care plan when they come out of hospital. They are lost, alone and vulnerable. The HSE's promise is to protect those in society who are ill and vulnerable. We tick all those boxes but such people are going home to their families. I was very fortunate that I had a husband and a wonderful family from both his side and my side who supported me, but people who are newly diagnosed and living with a chronic illness are afraid to go to sleep at night because they are afraid they will not wake up in the morning. They have chest pains and palpitations, but they are sent home with medication. There is no care pathway on discharge.

I had a hospital appointment yesterday. They are fantastic in CUH in Cork, which is where I go, but even they will say there are no supports. When someone is discharged, they go home to their family. Some are going home to an empty house and they do not have wood to burn, perhaps, as the Chairperson was saying. Those in houses that are poor have no one knocking on their door, no one making them dinner and no one helping them to go up and down the stairs because they are too breathless. There is no one setting up a bed downstairs because they are physically not able to get up the stairs. There is no public health nurse coming in to check on them. There have to be better care pathways for people on discharge for all cardiovascular diseases.

To touch on another topic, we talk about psychological supports. Thankfully, Croí and the Irish Heart Foundation have recognised that psychological supports go beyond the patient. They have to support those who are carers and who are caring for people with serious heart diseases or stroke survivors. The psychological supports have to extend to the wider family and that needs to be further resourced and built upon.