Noel Harrington (Cork South West, Fine Gael)

I welcome the opportunity to speak on this debate and I thank Deputy Maureen O'Sullivan and the Technical Group for introducing the motion. The incidence of stroke is likely to increase as the years go on if lifestyle and diet issues leading to obesity continue. Unfortunately stroke is one of the most debilitating and crippling conditions to affect the population with an immense cost to the State.

Perhaps I might be allowed to get somewhat parochial and reflect on the timely nature of the debate with respect to Bantry General Hospital where the Minister for Health officially opened the acute stroke unit last week. As an example of how progress can be made, the unit, which is the first of its kind in Cork and Kerry, admits more than 100 patients with acute stroke annually. It is a key part of the clinical programme in stroke for west Cork and south Kerry. It is a modest four-bed unit set up at the end of 2009 without any extra staff by reorganising existing resources.

Dr. Brian Carey, consultant geriatrician at Bantry General Hospital, has said that the unit has led to substantially improved patient outcomes and enhanced patient access to multidisciplinary team members and CT scanning. The acute stroke unit is located beside the rehabilitation unit to allow for a seamless transition between acute care and rehabilitation. In addition, there has been a significant impact on patient length of stay. Despite a 13% increase in acute stroke admissions since the unit was set up, the total number of bed days used by patients with acute stroke has declined by 35%. Approximately 1,400 bed days have been saved annually in one small county general hospital. Of an annual budget of €15.5 million, the hospital has managed to save €1.2 million, a not insignificant amount relative to the overall budget.

Staff working in the unit use the most up-to-date evidence-based protocols to deliver a high quality service to a rural, isolated population. Since its inception, the unit has facilitated the safe and efficient provision of thrombolysis, the potentially life saving clot-busting treatment. This treatment is so time-sensitive that if patients from the region where I live had to travel to Cork, they would arrive too late to receive it. Some 10% of patients received this clot-busting treatment at Bantry General Hospital in 2011, an outstanding achievement in one of the most peripheral hospitals in the country. That 10% treatment rate is twice the average seen in the UK.

The acute stroke unit provides high quality specialist care for people who have had a stroke. Nursing staff are experienced in the assessment, treatment, monitoring and management of patients. More patients will survive their stroke and more will return home rather than transferring to institutional care as a result of being admitted to the unit. In addition, patients will have less disability when they return home and spend less time in hospital. The care of patients in the stroke unit involves a multidisciplinary team of health professionals including nursing, speech and language therapy, medical, physiotherapy, occupational therapy and counselling. The success of the acute stroke unit at Bantry General Hospital has already been recognised by the award of a special commendation at the Astellas Changing Tomorrow Awards this time last year.

On behalf of all the patients I thank all the staff in the dedicated unit for their contribution to creating a better society in serving west Cork and south Kerry. Small hospitals such as Bantry General Hospital can contribute in a significant way to this treatment, possibly proportionately more significantly than bigger hospitals can. Paramedics and advance paramedics should be trained and tasked with administering thrombolysis to patients in areas where they may not be able to get it in clinical care. That is very important. It is not long ago since people did not know what cholesterol was. Now, it is a part of casual conversation and people can stand in the shop or at the water unit and say they have a level of 7.2, 3.4 or 6.5 and people know exactly what they are talking about. People know exactly what Lipitor is and what statins are and all about the care for stroke prevention. Unfortunately, despite all the care, dedication and advice about diet, exercise and lifestyle we will continue to see increasing numbers of stroke victims in the country. This is regrettable and this why we need dedicated units. I commend the work of this unit at this time of increasing pressure on budgets. They have sought no extra resources, money or finance. There have been no great protests or rallies. The care clinicians on this team went ahead and got together. They put together the protocols and achieved something that could be achieved in every hospital in the country if those involved were minded to consider it.

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