Mary Harney (Dublin Mid West, Progressive Democrats)

Rehabilitation is a core element of health services. It is fundamentally about enabling and supporting individuals to recover or adjust during this time, achieve their full potential and, where possible, to live full and active lives. Increased trauma survival, especially in the area of stroke, road traffic accidents and occupational accidents, has increased the need for rehabilitation. An increase in life expectancy has also affected the rehabilitative needs of the population. There is an increased awareness of the importance of rehabilitation especially in the areas of stroke and acquired brain injury.

Key aspects of rehabilitation services are meeting the needs of older people, those with an acquired brain injury and those with multiple long-term conditions who wish to live independently in their own homes. We need to improve interdisciplinary co-ordination of service delivery. In addition, we need to improve access and availability. The transition between services provided in hospital and the community requires to be considered also. These are all matters that will be enabled by our reform programme, particularly the new consultants' contract.

Over the past ten years a number of former health boards and, more recently, HSE regions have commissioned local reports and research in recognition of the complexity of needs presented by people with acquired brain injury and the challenge of meeting those needs. These reports indicate the need for a national strategic approach to planning and delivering rehabilitation services. This need has been recognised by Government and social partners in the partnership agreement, Towards 2016.

The Government is also committed in our programme to increasing rehabilitation bed capacity. My Department, together with the HSE, is committed to developing a strategy for the future of rehabilitation services, including a network of rehabilitation facilities. A working group is being established to define the scope of rehabilitation services, research best practice approaches to rehabilitation services, assess the needs of the population and outline a model of service delivery that will encompass all stages of service required to meet the needs.

The HSE has recently conducted a national review of neurology and clinical neurophysiology services. The review was undertaken in view of the increasing demand for services along with the rapid pace of technological advances. The review was overseen by a multidisciplinary steering group whose aim was to identify the current level of service provision and future requirements for neurology and neurophysiology services in Ireland. The objectives were to evaluate current neurology services, including paediatrics and neurophysiology; review the evidence in regard to models of service delivery; identify requirements for the development of neurology and neurophysiology services nationally and prioritise service requirements; and to report to the director of the National Hospitals Office. The HSE has advised my Department that work on the review has recently been completed and that the final draft report has been submitted to the director of the National Hospitals Office for consideration.

In recognition of the need to develop neurology and neurophysiology services, additional revenue funding of €3 million was allocated to the HSE in 2006. In 2007 further additional revenue of €4 million was allocated to support the continuing development of services in the area of neurosciences. The HSE has advised me that there has been an increase in the number of consultant neurology posts arising from this investment. In the area of neurology there are currently 24 approved posts of consultant neurologist in Ireland, of which 19 are filled. With the current recruitment, the remainder will be filled. This is an increase of ten approved posts since the Comhairle report in 2003. Three such posts were advertised last week. In addition, there are currently seven approved posts of consultant clinical neurophysiologist, of which four are filled. This is an increase of four since the Comhairle report.

The Comhairle na nOspidéal report on neurosurgery recommended that the future development of safe, high quality neurosurgical services in Ireland would be best served by increasing capacity in Dublin and Cork and by improving access to neurosurgical units, including improved transport and telemedicine facilities for referring hospitals.

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