Ms Alison Cotter:

I thank the Senator for the question and I thank the committee for inviting us here to discuss this important issue. I acknowledge the work of the Minister of State, Deputy Rabbitte, on this matter. We have had her support and commitment particularly for our own MS Ireland vital services. To use her own works in reference to the work of An Saol, we need to see such vital services become more accessible nationwide. I also acknowledge the work and commitment of the national neurorehabilitation strategy implementation group, which has great vibrancy and energy.

I am speaking here today with two hats on. I am the vice chair of NAI, but I am also representing a member organisation. We are very conscious of the issues facing section 39 providers of health and disability services. It is part of a much wider discussion outside the scope of what we are discussing today. However, I take the opportunity to highlight that it has direct bearing on the implementation of the neurorehabilitation strategy. There is major reliance on the voluntary sector to provide neurorehabilitation services in the community. The sustainability of these services is under threat due to critical underfunding. This is beyond the scope of today. It is a wider piece and with the understanding of the committee I will not go into it any further. I wanted to acknowledge the work of voluntary sector providers.

We want to address the role these voluntary sector providers play in providing specialist community neurorehabilitation services to respond to ongoing needs and maintaining goals beyond those 12 weeks. The community neurorehabilitation teams are one step on the neurorehabilitation journey; they are not the destination.

The key message from our perspective, and that of the voluntary sector, is about keeping people well at home. These teams are limited to that 12-week period, but people still have scope for improvement beyond that. As I say, it is not the end of the situation. It is also worth noting that some people living with neurological conditions may not qualify to access a CNRT. They may only have a need for one discipline such as physiotherapy, and you need more than one to qualify to access these CNRTs. There is also a need to transition from the medically unwell phase to integrating into society and keeping people at home. We are investing in this valuable rehabilitation. It is not expected to be a quick fix, nor should it be. What we voluntary sector providers do is enable people to maintain the gains beyond that, continue that improvement and enhance the effectiveness of that investment. Providing long-term specialist neurorehabilitation services in the community is so important in delivering the national neurorehabilitation strategy. We need to see proper investment year on year in developing community neurorehabilitation services in line with that strategy. We are not starting from ground zero here. As the Senator says, MS Ireland provides an on-the-ground, long-term community neurorehabilitation service. This is highlighted throughout the neuro mapping project published in 2023.