Ms Alison Cotter:

I thank Deputy Ellis for raising those important points. They touch on what Deputy Coveney asked about gaps and bolstering the services that are in place. Mr. Schäler mentioned there being a proven track record. We can see that in the delivery by the HSE and the Minister of the CDRTs. There is progress being made in that regard - there are no two ways about it.

In terms of the next step, the voluntary sector providers that make up the NAI, such as me in MS Ireland and An Saol Foundation, are providing the vitally needed services that support step 2, after the CNRTs. These services must be sustained and expanded to enable people to keep living well within their communities. The neurorehabilitation strategy itself refers to the crucial role of voluntary sector providers in the rehabilitation and long-term management of neurological conditions. The specialist nature of the services that we as voluntary sector organisations provide in bolstering the services that are in place cannot be overstated.

Ms Rogers picked up on the point earlier that the teams are one step in a rehabilitation journey. Neurorehabilitation needs to go on long beyond the 12 weeks. The CNRTs are only meant to provide a short burst of rehabilitation. There is a need for people to transition from a medically unwell phase and for those who are living with progressive and acquired neurological conditions to reintegrate back into society – to get back to work, for example, if that is something they want to do. It is all about person-centred care. We are not starting from ground zero in terms of those services. They are in place and they are being funded on the ground in regard to the longer term piece.

Deputy Ellis mentioned neuromapping. The report that was published in April 2023 found that nearly 100 unique services and supports were provided across the country, including supported living, respite, and vocational services. From our perspective, the value of those community-based services and their specialist nature for people living with neurological conditions is a lifespan piece. I will call out a couple of pieces where that is happening in practice, not only in MS Ireland but across the NAI. For example, the implementation framework outlines long-term rehabilitation services in the community as encompassing residential. As Ms Rogers outlined in regard to our national MS respite centres, we have had some wins in those areas. We are seeing investment there. We received an investment of €250,000 to keep us open seven days a week to the end of this year. The Minister of State, Deputy Rabbitte, acknowledged the importance of a good respite service being adequately funded and used to full capacity, especially in light of the difficulties we face in the sector. The gap is in the sustained support of those services, which really make a difference in the lives of people living with MS, but also other neurological conditions.

Acquired Brain Injury Ireland has transitional rehabilitation units. One property, for example, is in Sligo. It provides structured rehabilitation with one-to-one skilled rehabilitation assistance. It is person-centred, which goes to the heart of what the UNCRPD is all about. People who have used the centre argue that no two brain injuries are the same, so it is individualised. No two neurological conditions are the same, and the impacts on the person are not the same for any two individuals, even though they may have the same neurological condition. I know this is happening with our organisation in the physiotherapy programmes we provide to people with a range of neurological conditions. There is no good in these services existing in a silo. It is all about preventing crises and keeping people living well in the community should they wish to do so. An Saol Foundation has discussed the services it has.

On the vocational piece, Headway has been in touch as well about the extremely effective programmes it has in place, in pockets. Deputy Ellis mentioned bolstering services in CHO 9. Services are being bolstered in certain areas, but it is not happening across the country. Depending on where they live, people living with neurological conditions are not receiving the same standard of long-term rehabilitation. It is a postcode lottery at the moment. Even our own organisation has pockets where we do not have a service. That must change in order to enable people living with neurological conditions, including multiple sclerosis, to live well in their community and to get back into society.