Dan Neville (Limerick West, Fine Gael)

I welcome the opportunity to speak in this debate and I welcome the initiative of the Labour Party to introduce it.

In the 2001 health strategy, the Government promised to prepare an action plan for rehabilitation services for people with brain injury, recognising the shortage of inpatient and community-based services. The action plan was supposed to set out a programme to meet existing shortfalls in speech and language services, occupational therapists and physiotherapists.

Experts recommend that patients with a brain injury must be seen within two weeks to maximise recovery but Irish patients must wait up to two years for an initial assessment because we only have one rehabilitative hospital with 110 beds. That has only the capacity to treat about a quarter of the 10,000 people who suffer a brain injury each year.

In 2005, the Disability Act was promoted strongly and debated by my colleague, Deputy Stanton. This Act promised an independent assessment of needs for all people with a neurological condition. At the moment this is being rolled out to all children under the age of five but anyone over that age is not being assessed.

The HSE strategic review of neurology and clinical neurophysiology services was due to be published in February 2007. That review was given to the HSE last December but has still not been published. Why is this so and why can it not be debated? It is unacceptable that people suffering from brain injuries as a result of a car crash, stroke or other accidents or illnesses must wait as long as two years for rehabilitation services.

Access to early rehabilitative treatment is critical for helping people to talk or walk again. Although the health budget has never been larger, accessing services such as speech and language therapy, occupational therapy and physiotherapy has not improved. As a result of long waiting lists, patients are left in debilitating conditions, dependent on others at home or in nursing homes for the rest of their lives.

The Health Service Executive has commissioned three reports on neurology services, one in 2003, another three years later, and the last one was presented to the HSE in December 2007 but it has not been published. I wonder why it has not been published. Like the reports before it, the third report criticises the fact there are just 20 neurologists, nine neurosurgeons, six rehabilitation specialists and only 110 rehabilitation beds in the country. Services are seriously underresourced and it is having a devastating effect on patients.

The three reports indicate we have less than half the consultant neurologists required. With only 20 consultant neurologists, Ireland has proportionately the lowest number in Europe. The 2003 report found we needed 42 consultant neurologists, but after three reports within five years, we still have less than half the recommended requirement.

The HSE and the Department of Health and Children are fond of commissioning report after report, gathering information to establish and re-establish what we already know, but they are not so good at implementing the recommendations of their reports. They seem to consistently ignore them.

Since the IHF audit was published we have seen stroke units being named which will not be staffed or have enough beds to cater for the full throughput of patients. Arising from a presentation at the IHF stroke conference, the HSE announced that stroke units are in place in the Mater, St James', Clonmel, Navan, Sligo, Portiuncula, with Connolly and Kilkenny opening in the summer. Will the Minister and Minister of State confirm these units are staffed and bedded to cater for the likely throughput? The HSE and the Department of Health and Children are failing brain injury and stroke victims. Their function should be about providing medical care, not about drawing up reports that are ignored and maintaining a costly bulging bureaucratic behemoth that is denying resources to frontline services.

Stroke is the third largest cause of death and disability worldwide and constitutes a formidable burden of disability for patients, their carers and the wider community. Each year, approximately 10,000 people are admitted to hospital in the Republic of Ireland with stroke disease as a primary diagnosis. It is estimated that more than 30,000 people in Ireland are survivors of stroke and many of them have significant residual disabilities.

Neurological conditions affect approximately 700,000 people in Ireland. Such conditions are those which affect the brain and spinal cord. Many of them are common and treatable but early intervention is the key. As stated, there is only one hospital, with just 110 beds, in the country for those who suffer an acquired brain injury.

A report by Comhairle na nOspidéal, commissioned by the Government in 2003, recommended that 42 neurologists were needed to serve the Irish population. People are currently obliged to wait up to two years to see a neurologist for diagnosis and commencement of treatment. Neurological conditions need to be identified and treated as soon as possible. The delay to which I refer is completely unacceptable. The projected increase in the number of people with neurological conditions will place considerable strain on services already under pressure as a result of long waiting lists, lack of rehabilitation facilities and personnel shortages at all levels.

See this speech in context