Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I welcome the focus of this motion on stroke and stroke services. I commend Deputy Maureen O'Sullivan and her co-signatories for placing it on the clár of the Dáil. The motion describes very well the reality of stroke and how large it looms in the lives of the Irish people. It causes some 2,000 deaths each year, which is approximately ten times more than the number of people killed on our roads each year. It is the third largest killer of Irish people and the biggest cause of acquired disability. Those are startling and thought-provoking statistics.

Much credit is due to the Irish Heart Foundation for the work it has done on this issue. It reported last year that stroke-related hospital admissions had increased by 87% following the launch of its "Act FAST - face, arms, speech, time" campaign. Many people have been educated by the foundation's very effective television advertisements. That is very welcome indeed. According to research carried out by the Irish College of Surgeons, some 59% more stroke victims got to hospital in time to receive potentially life-saving thrombolysis treatment during the first phase of the advertising campaign in 2010. This increased level of awareness needs to be sustained and enhanced further because it is certainly saving lives. It is a disappointment to find, as the motion states, that of the €557 million in annual Exchequer expenditure on stroke, €414 million goes towards nursing home care for the one in six nursing home patients who are stroke survivors. This points to the great need for enhanced commitment to invest in stroke prevention and rehabilitation services. All the main parties committed before the general election to prioritise the elimination of avoidable death and disability in the shortest possible timeframe. Sinn Féin, the Fine Gael Party, the Labour Party and the Fianna Fáil Party signed up to this commitment and must work together in this Dáil with our Independent colleagues to fulfil it. Obviously, a special responsibility resides with the Government parties. Will they continue the legacy of their predecessors and neglect the need to support and develop rehabilitation for stroke survivors and others who require it?

Last year, when we asked the Minister for Health, Deputy Reilly, what action he proposed to take to improve the provision of neurological care he stated the office of clinical strategy and programmes in the Health Service Executive had established three key national programmes in neurological care. This, he added, showed the HSE's commitment to improving access to neurological services and gave these services a major focus in the HSE. He also noted that the third national programme "deals with stroke services and aims to establish robust clinical governance systems for stroke care, including local stroke teams and regional stroke networks."

I am aware, in speaking to the House this evening, of the proposed stroke unit at Cavan General Hospital and, regrettably, the key specialties yet to be secured at the hospital. Will the Minister advise the House of the current and projected status of this important and welcome development at the hospital? I hope progress has been made in the development of the third programme and wonder how effective such a programme can be in the context of the current unacceptable and seriously damaging cuts in the public health services.

Many Deputies will be familiar from representations they have received regarding the position at the neurological department of Beaumont Hospital, with its long waiting lists and shortage of clinicians. The position is that access to rehabilitation in this State is lamentable. In July last year, the National Rehabilitation Hospital, NRH, in Dún Laoghaire was reported to have 150 patients on waiting lists, some of whom had been waiting for up to a year. Lack of specialists and inpatient beds means that those with the most complex needs are often forced to wait longest. That said, once access is secured, patients receive the highest standard of care and support in the hospital. I am proud to note that the same can deservedly be said of the rehabilitation services at Monaghan General Hospital and congratulate all involved.

This State has the lowest number of physical and rehabilitation specialists in Europe. While the European average is approximately 3.3 consultants per 100,000 of the population, this State has 0.17 consultants per 100,000 citizens. The serious shortfalls to which I have alluded must be addressed. Education and awareness raising are vital in stroke prevention and coping with strokes when they occur. Equally, services need to be in place for survivors of stroke and all those who require rehabilitation. I commend the motion again and urge all Deputies to support it.

See this speech in context