Ms Magdalen Rogers:

The cost of the rehabilitation piece is very important in the context of what Deputy Tully said. My colleagues here from An Saol Foundation and MS Ireland have addressed the longer-term costs but there are also the immediate costs, such as the bed days lost when people are not being transferred out of acute hospitals because there are no rehabilitation places. There is actually a recent report issued by the HSE on the issue of delayed transfer of care because of not having rehabilitation services. I will ensure the Deputy gets a copy of that report. That work has been done and it highlighted a really important point, which is that neuro rehabilitation needs to be put in place for many reasons, including for the effective running of our health services. There is a need for that transfer to be available in order that people can move from acute care that is really very good onto the longer-term support services.

The Deputy asked a very good question on what has been done and what needs to happen. We have seen the progress from the outset and we have all said from the outset that there needs to be nine community neuro rehabilitation teams around the country. We still have gaps in that regard. We have two major gaps in the neuro rehabilitation strategy at the moment. A HSE report issued just last week showed for the first time the extent of the gap when it comes to inpatient beds. We always knew there was a very significant deficit in neuro rehabilitation beds. The HSE report last week is stark. On the overall deficit, we have a 58% shortfall in the number of neuro rehabilitation beds in the country. What is that doing? It means that people in the regions are not getting access to neuro rehabilitation in a rehabilitation setting. It also means that the National Rehabilitation Hospital, NRH, in Dún Laoghaire is becoming a funnel for all neuro rehabilitation referrals, which it was never meant to be. It is a complex specialist centre for a particular type of rehabilitation. However, there is now such pressure on the NRH that we see waiting lists of three to six months. We have almost become used to long waiting lists in the NRH. We almost do not question them anymore. As a result of that lack of beds around the country, everything is funnelling into the NRH.

Finally, we have a major gap in long-term rehabilitation services. Organisations such as MS Ireland and An Saol Foundation provide pockets of service, but we do not have them throughout the country. We do not have equal access to them. Those are the two pieces where the neuro rehabilitation strategy still has a lot to do.