Thomas Pringle (Donegal South West, Independent)

I welcome the opportunity to contribute to this debate on stroke services. Every year, 10,000 people will suffer from strokes and 2,000 of these will die. Many more will become disabled and dependent on services for the rest of their lives.

Unfortunately our health services are reactive rather than proactive. It is vital that we develop services to prevent strokes. The Private Members' motion welcomes the increase in the number of stroke units because despite the cutbacks being implemented in the health service we must ensure stroke units continue to be rolled out and made available to patients across the country.

Prevention is definitely better than cure in the case of strokes. Up to 50% of strokes can be prevented and in this regard awareness is crucial. The Irish Heart Foundation's face, arms, speech and time to call 999, FAST, campaign has produced results even at this early stage. A survey by the foundation found that admissions to hospitals relating to stroke symptoms increased by 87% over the lifetime of the campaign. The Royal College of Surgeons in Ireland conducted another study which revealed that the number of patients getting to hospital in time to be treated increased by 59%. As the FAST campaign reminds us, time is of the essence. Disturbingly, it appears that awareness is tailing off as funding for the advertising campaign comes to an end. It is vital that the campaign is supported if we are to get the best outcome for stroke sufferers by getting them to hospital on time.

The foundation spent €250,000 on the campaign, of which €50,000 returned to the State in VAT and other charges. This is something that needs to be seriously examined because that €50,000 would have been better spent on prolonging the campaign. The value of the campaign is there to be seen. By maximising the amount of funding available to it, we can ensure it has a long-lasting impact on stroke sufferers' outcomes.

The Department of Health states that 90% of all admitting hospitals will contain stroke units. That is welcome news because the value of such units cannot be overestimated, especially where units are integrated with care teams and rehabilitation services. The quicker one gets into rehabilitation, the better the outcome and the opportunity to return to society to leave a full life.

In 2009, only 3% of stroke patients received thrombolysis treatment. That is an amazing figure when one considers the life saving impact of the treatment in terms of preventing further implications of stroke. In many hospitals it is only available during office hours. Thrombolysis treatment should be available on a 24-seven basis to anyone who needs it.

Aftercare in the community is hugely important for stroke sufferers. Unfortunately, however, the quality of aftercare depends on where one lives and whether local health management is proactive in providing services such physiotherapy and occupational therapy. These services are suffering from the embargo on HSE recruitment and testimonials from stroke sufferers reveal the repercussions. One sufferer was waiting for physiotherapy for two months because the physiotherapist was out sick without cover. Another sufferer who had contacted a doctor to arrange physiotherapy heard nothing back for a year.

The cutbacks do not make sense because people who can get the services they need to get fit again will be able to return to work and fullly participate in the community, which is more economical in the long term. Too often funding is decided on a year-to-year basis when the longer term payback times should be taken into account. By investing that money now, the State will save money in five years time. Investment in care saves money. The Irish Heart Foundation estimated that rolling out full stroke services across the country would be cost neutral at minimum. That estimate should be sufficient enticement to ensure it happens. We already spend €422 million per year on stroke care and if that can be cost neutral or save money in the future, we would achieve the best outcome for everybody.

It is estimated that 50% of strokes are preventable. That is equivalent to 5,000 strokes and 1,000 deaths. They are totally preventable if we get it right.

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