Gerald Nash (Louth, Labour)

I doubt there is a family in Ireland that has not experienced the affliction of stroke. Strokes, as the Minister of State knows, can vary from relatively mild occurrences from which people can and do make full recoveries to devastating attacks which greatly impair the quality of life of patients and their carers. Once, we viewed strokes almost as an act of God. There was nothing we could do except sit and hope that a sufferer would regain some functionality. Thankfully, we have come a long way since then.

Last year, as the Minister will be aware, the Irish Heart Foundation published ESRI research showing that 750 extra people could be saved from death or lifelong dependency each year, with a cost saving to the taxpayer of €230 million over the next decade, if stroke unit care and clot-busting thrombolysis treatment was generally available. The HSE accepted this research and, in fact, allocated an extra €4.2 million to stroke services in the 2011 service plan to fund the appointment of 45 clinical nurse specialist and therapist posts countrywide. These were in addition to a number of new consultant neurologist and geriatrician appointments that are currently being made. Two of these posts were approved for Drogheda - a clinical nurse specialist and a therapist - with the full expectation that they would be filled early this year. We are almost at the year end and, apparently, these posts are no closer to being filled. It is essential to understand that an effective, functioning stroke unit is made up of people, not simply buildings and equipment. A stroke unit requires people with the necessary expertise who altogether offer a holistic approach to patient care. As the Minister of State is aware, when done properly the results are spectacular in terms of the recovery of patients and, crucially, in terms of reducing the likelihood of further attacks and incidence. Without the required expertise there may be a "Stroke Unit" sign on the corridor but it will not meet the guidelines of what constitutes a stroke unit as envisaged by the Irish Heart Foundation and the ESRI and, therefore, the benefits and the savings will be lost.

We are all aware of the difficult situation this country is in but this is not a case of seeking additional resources; the budget for these posts has already been approved. What is more, these appointments will greatly improve the effectiveness and efficiency of our stroke care system, saving money and freeing up resources to meet other demands in the health service. This is a win-win situation and it is deeply frustrating to see such a delay in implementing a measure that will greatly improve quality of life for patients and their carers. I appeal to the Minister of State to give this her full attention and to ensure these two essential appointments are made as quickly as practicable.

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