Kathleen Lynch (Cork North Central, Labour)

I compliment the Technical Group on the debates it has initiated in recent months. It has used Private Members' time to great effect.

Language is very important. As someone who spent a good deal of my life promoting women, I know how effective, damaging or undermining language can be. That anyone believes there are no standards in private nursing homes is quite astonishing. Private nursing homes are inspected in the same way as public nursing homes so they meet particular standards and the quality of care is the same, despite what the Deputy believes. In some areas, people have higher needs but the standard of care is the same and we should be careful how we say things because people listening will be worried about their loved ones.

I am pleased to have the opportunity to make a concluding statement on the subject of stroke rehabilitation services for stroke survivors and persons with neurological conditions. The debate has centred on what can be done to prevent stroke, rightly so. I thank Members for their helpful contributions on the burden of stroke and the measures to prevent disability from stroke and other neurological conditions. The 2010 cardiovascular health policy established for the first time a framework for the prevention, protection and treatment of cardiovascular diseases, including stroke. The work has been taken forward by the national stroke programme to help lead and co-ordinate the development of stroke services in Ireland. This arose from the Irish Heart Foundation, which should be complimented. I was astonished when a neighbour of mine, a young man, had a stroke a few months ago. The symptoms were recognised very early by his 12 year old son. We asked the son how he knew and he replied that he had seen the Act FAST advertisements on television. Subconsciously, it is sinking in. An early priority was the development of acute stroke services, illustrated by the increase in stroke units from one in 2006 to 26 in 2011. An additional two will open in early 2012. This means that over nine in ten stroke patients will have access to stroke unit care. The HSE has also provided additional therapy and nursing posts with specific responsibility for strokes. This will enhance rehabilitation services and help to reduce the burden of the condition.

A number of specific issues were raised in the debate, which I would like to address. Several Deputies referred to the work of the Irish Heart Foundation. A revenue stream is provided by the HSE to the Irish Heart Foundation and the current provision of services in the National Rehabilitation Hospital will be reviewed with the hospital to identify ways of managing the needs presenting to the hospital in the most efficient way. Recruitment to fill posts for the stroke unit at Cavan hospital is ongoing and the unit is open. Neurological services in Beaumont Hospital are being further developed by the HSE, with the recruitment of a neurologist later this year and additional staff and beds to support the epilepsy service for the region.

Regarding alcohol, last week the report of the national substance misuse strategy steering group was launched. The report contains a range of measures relating to availability, prevention, treatment, rehabilitation and research. The recommendations of the steering group on alcohol will encourage public debate and I envisage an action plan being developed in advance of proposals being drafted for the Government.

I am pleased that smoking has been raised in this debate, as it is a major risk factor for stroke. Ireland has a good reputation on tobacco control legislation. However, we must continue to build on the work done in order to tackle the problem, which results in approximately 5,200 deaths every year. A tobacco policy review is currently under way and will cover areas such as smoking in cars in the presence of children and improving the quality and effectiveness of our smoking cessation services. It is essential that we de-normalise smoking and I anticipate that the report of the tobacco review group will go some way to assisting us in this regard.

During 2012, the Minister for Health established a special action group on obesity. The group is broadly representative and is concentrating on a range of measures, including healthy eating guidelines for the Irish population, calorie posting in restaurants, nutritional labelling, the promotion of physical activity and the detection and treatment of obesity. The group will work with other Departments on a cross-sectoral basis to help halt the rise in overweight people and obesity.

I had the pleasure to publish the national policy and strategy for the provision of neurological rehabilitation services in December. I welcome the publication and I realise the actions recommended will provide real challenges, especially in our current financial landscape of resource constraints. I note the commitment of the HSE and service providers to the implementation process. We can achieve improved rehabilitation services for those with a neurological injury or illness or a significant physical disability. The strategy is focused on the specific needs of those with neurological illness or injury, outside of stroke. Five of the more common neurological conditions were selected for detailed review and analysis. The five conditions were acquired brain injury, cerebral palsy, multiple sclerosis, idiopathic Parkinson's disease and spinal cord injury. The challenge is to ensure provision is appropriate to each individual and the structure supports this provision and an appropriate governance framework is in place. We have the policy strategy, now we need an implementation plan and I look forward to receiving it from the HSE. There is cross-sectoral commitment to continue to improve services for stroke survivors and those with neurological conditions. Such commitments can only help to ensure the burden of stroke and other conditions is minimised for patients and their families. As mentioned by Deputy Halligan, having primary care teams fully fleshed out in the community can only help this area.

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