Jan O'Sullivan (Limerick East, Labour)

I thank my colleague, Deputy Kathleen Lynch, for tabling a motion that sets out a highly comprehensive case on behalf of the Labour Party and for giving me some of her allocated time. I also welcome the many people present in the Gallery this evening, many of whom have direct experience of the issues under discussion. Representatives are present from such organisations as Headway Ireland, Brí, Brainwave, the Peter Bradley Foundation and the Neurological Alliance of Ireland, as well as ordinary families who have been hurt by acquired brain injury in a variety of ways. I refer to those who have directly experienced such a brain injury, as well as their nearest and dearest. The Labour Party Members hope that by proposing this motion tonight, they will be able to make a difference with regard to their experience and lives.

I am concerned that this debate is taking place at a time when one hears of cutbacks throughout the services provided by the HSE. One reason the Labour Members have used their scarce Private Members' time on this issue is that sometimes, in a time of cutbacks, such groups are left aside and their voices are not always heard in the clamour for resources. The Labour Party Members wish to ensure that those who have acquired brain injuries and their families are not left behind at a time when one hears of cutbacks throughout the service.

I am concerned that one hears of the long-needed development of service being abandoned, simply to keep the service going without any changes in the manner in which it is run. Unfortunately, this is a real concern. Deputy Kathleen Lynch is correct that we know what must be done and where are the gaps in service and waiting lists. Waiting lists exist throughout the services for people with acquired brain injuries. For example, a two-year waiting list is in place for neurology services, which is appalling. I understand that although a neurology report has been available since December 2007, it still has not been published. Tonight I call for the report's publication and implementation because a two-year waiting list for neurology services is completely unacceptable.

Waiting lists obtain throughout the service in Ireland, which lacks the kind of linkages and automatic progression that should be present. Those who have worked in such services in other countries can give examples of what happens when someone is admitted to an accident and emergency unit with a brain injury after a serious traffic accident. Such people are dealt with in the accident and emergency unit and thereafter, if necessary, are dealt with by a neurosurgeon. Subsequently they move onto rehabilitation, which is followed by a move to community services. There is linkage of, and a seamless flow to, the services and there is no delay. In respect of acquired brain injuries, Members know how important it is to provide the service as quickly as possible to the person concerned. A couple of hours can make an enormous difference in respect of a traumatically acquired brain injury, perhaps through a road accident, to someone who suffers a stroke or to someone who acquires an brain injury in another fashion. Such an immediate reaction can make life-transforming differences for the people affected. However, this does not happen because we lack the services that people need.

This would be money extremely well-spent. Those who can benefit from the required interventions at an early stage, such as those who, for example, can get a bed in the National Rehabilitation Hospital in Dún Laoghaire when they need it, enjoy a better quality of life and much greater opportunities to participate fully in their community, return to work or to avoid needing long-term services. Regardless of whether one balances this issue in respect of quality of life, which is much more important, or discusses the cost of the services, the provision of such services when they are needed for the people who need them constitutes a win-win outcome either way.

Deputy Kathleen Lynch has outlined the Irish statistics whereby approximately 10,000 people per year suffer an acquired brain injury, as well as the absolute inadequacy of having only 110 beds for those people. Quite detailed studies have been carried out in this regard. For example, a study was carried out in the Glasgow area on behalf of the British Medical Journal that indicated the potential throughput and results that can be and were achieved when a proper service is provided. A Royal College of Surgeons of England working party produced a report in 1999 that outlined the processes that were needed. This is the kind of strategy to which Deputy Lynch has referred. However, they put it in place in 1999 and are implementing it and providing such a service at present. The Labour Party Members call for the service to be provided without being obliged to wait. While they certainly would welcome a national strategy, provision of a service should not be obliged to wait for the development of a national strategy that may take place well into the future.

In particular, I wish to discuss the services that are required in the community and the motion calls for a series of regionally-based services. Practically every family in Ireland has experience of what it is like when a family member acquires a brain injury. It affects the whole family. Courses are held in the National Rehabilitation Hospital in Dún Laoghaire for family members who are dealing with a loved one's acquired brain injury. However, as the courses are held in Dún Laoghaire, the affected families are obliged to travel there to attend them.

I spoke to someone today who has a family member who recently acquired a brain injury. Such people talk about the various important services and of the cost to families at times of being obliged to travel to such services, or of being obliged to access them in the private sector when such services are unavailable in the public sector. In the brief time available to me, I wish to quote from a document that outlines one particular experience. The person concerned is a young man who was injured in a road traffic accident:

[He] was without physiotherapy for 9 months in 2006-7 and the physiotherapist has over 200 clients — now how could she deliver any service to each person on her case load. The same with the occupational therapist. He is unable to deliver the type of service that would be appropriate for a person with [acquired brain injury] and he has over 200 clients also. If a clinician is on leave or leaves the service, there is no plan for backup and there is no one to fill in so the clients are just abandoned.

There is no psychologist in the service and even if there was it would be the same thing — over 200 clients in the service waiting for services. They have not had a psychologist for over 3 years and the psychologist assigned to work sessionally with him had no idea how to work with a person with ABI and has now left due to illness. He has had an hour a week of psychology (privately provided by the HSE) by a psychologist who works part time for the HSE and part time privately providing services (to the HSE). He is not part of the multi disciplinary team and is not engaged with programme planning, staff training, etc. etc. as recommended. The HSE does not have medical expertise available to this service nor does it have brain injury expertise as recommended. There is no vocational or day service in the area specifically for people with brain injury and no support or outreach service and no emergency services.

All Members are familiar with the enormous obstacles that those who have an acquired brain injury must overcome. Lately, I have been involved with a pilot programme for Headway in my native city on a group that oversees the programme, together with representatives of FÁS, the VEC, the HSE, etc. I have been enormously impressed by the work done by organisations such as Headway and the others. A great deal of voluntary effort takes place, as do enormous efforts by those who possess acquired brain injuries. They must put a great deal of work into their own recovery. The State must respond to their needs and one cannot simply allow the service be as minuscule as is the case at present. Although Deputy Lynch referred to the amount of money that has been invested in the health services, other countries appear to be able to implement such services and to be able to respond to the needs that exist. We also must do so.

I also wish to refer to one or two matters because I tried to consult with and talk to as many people as possible. Some of the specific issues that people raised include memory assisting technology, which costs €2,000 per person, card recognition, which allows someone to present a card that outlines his or her brain injury, and the failure of disabled driver VRT to cater for the needs of people with acquired brain injuries. Compulsory motorbike helmets were also recommended. I have a list of issues, the most important of which is the need for a full service that can support people with acquired brain injuries.

See this speech in context