Mary Upton (Dublin South Central, Labour)

I welcome this opportunity to contribute to the debate on the serious issue of acquired brain injury. It is often stated that a society is judged on how it treats its most vulnerable. If that is the case, I fear we are failing badly in respect of those with acquired brain injuries. We are also failing their families, friends and carers and those professionals who are working with them and doing their best to deliver a quality service in absolutely impossible circumstances and unbearable conditions.

If one applies international studies to Ireland, one discovers that between 9,000 and 11,000 suffer from acquired brain injuries each year. In addition, some 30,000 people are living with long-term problems following brain trauma and over 7,000 people suffer strokes each year. I accept that these figures were already alluded to but they bear repeating, particularly in light of the huge numbers of people in respect of whom poor-quality services are being provided.

Every brain injury is unique and a fully complemented staff of neurologists and neurosurgeons is required accurately to assess its extent and the level of treatment required. The very least to which those afflicted with such injuries, and their friends, families and those who work in this area, are entitled is that the Government, without delay, should increase the number of neurologists and neurosurgeons to the level required by our population base. As Deputy Sherlock stated, this would bring us up to the European average, namely, 16 neurosurgeons and 42 consultant neurologists. Furthermore, there is a need to ramp up our rehabilitation services. As previous speakers stated, there is only one rehabilitation hospital in the country, at which there are only 110 spaces available. Priority must be given to addressing this appalling situation.

Non-critical care represents the greatest hope for people across the health services. It can give a patient an opportunity to recuperate in a non-acute centre, offer him or her the chance to redevelop his or her independence skills in more familiar surroundings and help ease the pressure on our critical and hospital services by freeing up beds. When the HSE is required to trim its sails, it immediately targets non-critical care. There is evidence of this in my constituency in the aftermath of the decision to cut roll-over respite care in Cherry Orchard. The level of such care was also reduced at other respite centres throughout the country.

I received a telephone call from an extremely distressed constituent this afternoon. The woman's husband suffered a stroke and she wants him to remain at home. The city council will provide some funding towards the provision of the facilities she requires in her house. In order to provide her husband with care, she also requires a top-up grant. However, top-up grants are no longer available from the HSE. The woman to whom I refer consulted me to discover where she might obtain the additional funding necessary to allow her husband to remain at home in the environment with which he is familiar and also to relieve the burden on the State. However, the money is simply not available.

The Labour Party's motion calls for the establishment of a regional network of rehabilitation facilities. This is not an unrealistic request. The report, Acute Hospital Bed Capacity Review: A Preferred Health System in Ireland to 2020, published in January states that community-based services have a vital role to play in meeting our hospital bed space requirements in the future. The Government and the HSE must realise that regional rehabilitation centres form part of a cogent, long-term strategy to develop community-based non-acute services that are decentralised and present the opportunity for people to leave hospitals or long-stay care facilities.

Central to all of this is the provision of the various forms of therapy. I refer here to physiotherapy, occupational and speech therapy, which are crucial to ensuring patients can make a full recovery. The groundbreaking Bacon report, published in 2001, stated that a major expansion is necessary in the number of therapy professionals in order to pre-empt a persistent and growing deficit in our service provision. I wish to draw attention to another major anomaly in the system. In response to the Bacon recommendation to which I refer, the number of college places in occupational therapy and physiotherapy has significantly increased in recent years, particularly since 2003. While the number of graduates has also increased, the employment opportunities on offer from the HSE have declined. The latter is in part due to the HSE's recruitment freeze last year and the cutting of many so-called non-essential services, such as roll-over respite care in many centres. Figures from the Irish Society of Chartered Physiotherapists indicate that 89 physiotherapy posts that were in place prior to the HSE recruitment pause no longer exist and many of the current temporary posts will not be renewed. While the Government is providing college places for physiotherapy students, there are no jobs for them when they graduate. That is a problem for both the graduates and those who require, but are not being provided with, physiotherapy services. Physiotherapy, occupational therapy and speech therapy are essential services to those striving to regain a better quality of life. If these services are denied, then those with acquired brain injury face a bleak future. I urge the Minister of State to address as a matter of urgency the shortfalls in the many facets of treatment and services for those patients dependent upon them.

Despite all the issues that have been raised here, many people are urgently in need of support. One of the most demanding services in terms of the provision of family care is for those with acquired brain injury. Stroke is one of the most commonly acquired brain injuries and many of us are familiar with it. Historically it was often associated with older people, but unfortunately I hear quite regularly of young people who are suffering from stroke. They also need the chance of rehabilitation. They require services such as physiotherapy, speech therapy and occupational therapy that are so important to their rehabilitation. In that way they can regain a place in society and will have an opportunity to lead a full life of quality. What does it say about this Government and this country when such people do not have access to hospital beds, neurosurgeons, neurologists or therapists? We have heard so much about the financial resources that were available to us in recent years. However, while we provide further physiotherapy courses, encourage people to pursue them, produce graduates and make professionals available, we fail to provide such services to those most in need of them.

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