Ms Magdalen Rogers:

I apologise; unfortunately, we do not have representation from the neurology clinical programme this morning. On behalf of the Neurological Alliance of Ireland, NAI, the national umbrella for more 30 neurological charities, I thank the Chair and members of the committee for their invitation today to consider the implementation of healthcare strategies for neurology and neurorehabilitation services. Members of the committee attended our briefing in the AV room on 24 April, when we outlined the challenge for our health system in responding to the needs of the 50,000 people diagnosed with a neurological condition each year. More 860,000 people throughout Ireland are currently living with a neurological condition and that number is set to increase significantly with our growing and ageing population. Following on from the NAI's presentation in May of last year, we welcome this further opportunity to outline to members of this committee the progress that has been made and challenges that remain.

Unfortunately, while we have seen significant investment over the past three years to implement national strategies for neurology and neurorehabilitation, this legacy of progress is at serious risk of being undermined by the ongoing recruitment moratorium and delays in delivering on commitments that have been made to people with neurological conditions, their families and communities. On neurology services, we thank the committee for its support in response to our 2022 call for action to tackle the shortage of 100 specialist neurology nurses. Thanks to its support and representation, and the interest and commitment of Minister of State for disabilities, Deputy Rabbitte, funding for 21 specialist nursing posts was announced in October 2022. Unfortunately, the benefits of this significant investment have yet to be fully realised in hospitals throughout the country in Cork, Waterford, Sligo, Limerick, Galway and Dublin because 13 of these vital nursing posts are held up within the current recruitment moratorium. We are also going to highlight the issue of regional inequities that exist in access to outpatient neurology services. The NAI is calling for funding in this year’s budget to begin to tackle this inequity by investing in five consultant neurology posts to support hospitals in Portlaoise, Bantry, Wexford, Letterkenny and Mayo.

On neurorehabilitation services, we have engaged regularly with this committee over the past two years in relation to the delays in implementing the 2019-21 implementation framework for the national neurorehabilitation strategy. Again, we recognise some positive Government progress towards its commitments in the Sláintecare action plan and the current programme for Government on the neurorehabilitation strategy. Our call to expedite the roll-out of nine community neurorehabilitation teams across the country saw funding allocated by Minister of State with responsibility for disabilities, Deputy Rabbitte, for four teams across two successive budgets in 2022 and 2023. Unfortunately, as we will highlight today, the delivery of this important commitment to communities is also being impacted by delays. The promise to this committee last May to see teams in CHO 2, CHO 4, CHO 6 and CHO 7 fully functional by early 2024 has not been realised. A full year on, we still have the same situation we outlined to the committee this time last year, where only two of nine teams are up and running nationwide.

Community neurorehabilitation teams represent one of three key deliverables from the national neurorehabilitation strategy. The other two key commitments from the strategy are the delivery of long-term community neurorehabilitation services and inpatient neurorehabilitation beds. We need further investment to support the delivery of longer-term community neurorehabilitation services beyond the maximum 12 weeks of intensive rehabilitation provided by the community neurorehabilitation teams. It makes little sense to invest in intensive short-term rehabilitation if we cannot support individuals in the longer term to return to or retain their employment, maintain their independence and to live well with their neurological condition. The majority of these services are delivered by the voluntary sector, as will be outlined by my colleague, Ms Cotter. Research published in 2023 by the NAI, the Disability Federation of Ireland and the HSE showed that nearly 100 unique supports are being delivered on the ground in communities by voluntary providers to people with neurological conditions and their families. This Government has made some important investments in long-term community neurorehabilitation services in the 2024 HSE service plan, but it is May 2024 and funds still have not been released to enable these vital services to be delivered on the ground by voluntary providers.

The third deliverable from the national neurorehabilitation strategy is a commitment to tackle the shortage of specialist inpatient neurorehabilitation beds throughout the country, especially outside of Dublin. We know that we need 300 beds for the Irish population and that we fall far short of this. The most recent major trauma audit report in 2021 highlighted that the proportion of major trauma patients who received rehabilitation in an inpatient setting declined from 10% in 2020 to 7% in 2021. We thank the committee for the opportunity to highlight these issues and ask for its support for our key asks today as follows: to enable the funds that have already been committed to specialist neurology nurses and community neurorehabilitation services to be actively translated into actual services on the ground; to request that the HSE deliver an immediate action plan within a timely timeframe to tackle the shortage of inpatient specialist rehabilitation beds; and to begin to tackle the regional inequity in access to consultant neurology services by providing funding in this year’s budget to support the development of dedicated outpatient neurology services for Portlaoise, Bantry, Mayo, Letterkenny and Wexford hospitals.