Ms Alison Cotter:

There is no point in investing in this valuable rehabilitation unless it is followed up, like Deputy Conway-Walsh has highlighted. That is being done by our voluntary sector organisations. This matter has been highlighted in the strategy and in the neuro mapping project, details of which were published at the end of last year. Nearly 100 unique supports are being developed on the ground by community voluntary providers for people with neurological conditions and their families.

I have discussed the services provided by MS Ireland. In terms of the human impact of that, we have a lady who uses our national MS respite centre. Her daughter has been diagnosed with MS and her husband had MS. This woman is now 89 years of age. She has been a primary carer for most of her life. We have been told that the only reason her daughter is not in residential care is because of that service.

In terms of transitional rehabilitation, which has also been called out under the neurorehabilitation strategy, I know that acquired brain injury is dealt with in a traditional rehabilitation unit. I am conscious that I am here as the vice chair, and not just for my own organisation, which enables survivors of brain injury to return to their own homes or to more independent living within the community. Many people who have availed of that service have testified that they dream of returning to work to mentor future carpenters, which this person called out, or even becoming a lecturer. The service is just about keeping people well and living in their communities.

In terms of our services, for over 25 years MS Ireland has provided physiotherapy programmes for people with MS. We have had extremely successful Sláintecare integration fund projects and we have developed specialised online physiotherapy, which was developed during the pandemic.

On enhancing the effectiveness of investment, and I hate to bring the discussion back to numbers, there has been a reduction of healthcare utilisation just from this physiotherapy service alone, with a 43% reduction in health utilisations being reported, a 57% reduction in hospital bed days and a 49% reduction in falls. People living with MS tend to fall at the same rate as those over 85 years of age.

In satisfying that dual primal need, it is about ensuring people are well in their communities where they do not need to access these services which we know are going to be so in demand. It is also about ensuring that afterwards, people can avail of services that enable them to maintain those gains. There is currently a post-rehabilitation void. People may go home and may lose the gains they had which makes that investment null and void. These services pay for themselves in the long run. Research has shown that delaying or reducing disability due to MS reduces costs to the Irish health system by €19 million a year. I will also note, as Deputy Conway-Walsh has said, that there was scope for expansion of this and a submission was put in. We have received a commitment on that submission but nothing has been delivered.

In other services, Headway Ireland have locational rehabilitation which is also called out under the neurological rehabilitation strategy and it has very effective programmes in place, but this is in pockets. This is not available everywhere. I know that it is not available in Dublin, for example. This is a snapshot of the services provided by ourselves and the other 30 organisations under the NAI, and they all follow that key theme of enhancing the effectiveness of the community neurorehabilitation teams, CNRTs beyond that 12 weeks. It is about life beyond that intensive rehabilitation and enabling people to maintain those gains, to live well and to integrate back into society.

Our message is very simple. We need to see the further investment to deliver longer term treatment in our rehabilitation services beyond the maximum 12 weeks of intensive neurorehabilitation provided by the CNRTs. It makes very little sense - this has been called out by my colleagues - to invest in intensive short-term rehabilitation if we cannot support individuals in the longer term to return to or retain their employment, to maintain their independence and to live well with their condition. As Deputy Conway-Walsh has called out, this is about the people and families at the centre of this. If we do not keep them in our focus and to invest in this longer term rehabilitation, investment in this shorter rehabilitation piece will not work in the long term. I thank the Cathaoirleach for this extra time.