Clare Daly (Dublin North, Socialist Party)

It needs to be registered that we are discussing thousands of unavoidable deaths and thousands of people who could escape lives of unnecessary disability and dependency if we invested adequately in suitable stroke services. This, of itself, is of major significance. As previous speakers noted, 10,000 people will suffer a stroke this year and the condition is the third biggest killer in society.

While the fact that the House is discussing stroke is significant, I do not agree with Deputies who consider this to be some new departure and believe we are all on the same side. The Government tabled an amendment to water down the motion and secure agreement. We cannot separate health and well-being from overall economic policies and the poverty many people are experiencing and hollow slogans from Government Deputies will not change that fact.

We must not consider this issue in isolation. There is no point having best practice in stroke care if the rest of the health service is falling apart. A stroke victim who recovers and feels great may be subsequently admitted to hospital to have a baby or have a broken leg treated only to find the health service is in bits and underfunded and proper treatment is not available. This discussion is taking place in the context of cuts in the health service budget amounting to €2.5 billion over three years, most of which will be directed at primary and community care.

A policy for dealing with strokes is in place, medical knowledge of strokes is available and we know what needs to be done. While I welcome the increase in the number of stroke units and efforts to promote healthy lifestyles, the question arises as to what happens to stroke victims when they leave hospital or a dedicated stroke unit. We want them either to go home or to move to a nursing home for care. The Government is butchering care provided in both these settings. We cannot ignore the fact that it has slashed home help services and the assistance provided to people in their homes. This year, Government cutbacks will result in the number of people who access home help services falling to 5,000 below the 2008 figure and underfunding will lead to a reduction of 2 million home help hours. How will this help stroke victims recover in their homes? Other Deputies highlighted cuts in the carer's allowance. This issue must be also addressed if we want people to live independently in their own homes. The Government cannot square this circle.

People are enabled to return home by the services provided by a range of health professionals such as physiotherapists, speech therapists, occupational therapists and dieticians. Many stroke victims require modifications to their homes to accommodate and support new needs they may have acquired as a result of a stroke. As Deputies are aware, occupational therapy services are in crisis. In many areas, they are not available meaning the modifications stroke victims and others need in their homes are not carried out and they are unable to return home. If a person who has had a stroke manages to have an occupational therapist write a report, the local authority will inform him or her it has run out of money and cannot grant aid improvements in the house to enable him or her to return home. The Minister will be aware of such cases in his constituency and county. This failure causes people to stay in hospital, with all the effects this has on their quality of life, and creates a major drain on hospital resources.

The other option is to provide nursing home care to allow stroke victims to recuperate before returning home. As the motion points out, one in six nursing home residents is a stroke victim. Against that backdrop, how can the Minister argue that he wants to assist stroke victims while at the same time pursuing a policy of closing community nursing homes? This afternoon, I attended an excellent presentation by residents of St. Joseph's community nursing home in Ardee and their family members. As with residents of Crooksling nursing home in Brittas and other nursing homes, the residents provided graphic examples to demonstrate that supporting community based nursing homes is the most economical and efficient option from the Government's point of view. This type of care enables people to obtain good quality care.

As I have noted previously, one cannot compare the private sector with the public sector because private nursing homes do not have standards and public nursing homes have higher quality health care workers.

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