Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

Ba mhaith liom buíochas a ghabháil leis an Cheann Comhairle as ucht an deis seo a thabhairt dom an cheist seo a ardú. I know this matter was selected before the recess but I waited so that the Minister could address it in the Chamber.

Like me, I am sure she has had family and friends who have suffered strokes. We know not just about the medical side of stroke, but the psychological and emotional effects it has on the victim and on those who love them. We know also that there are personal, emotional and psychological costs along with the physical ones. Stroke is a life-changing experience.

Every year, the financial cost of strokes comes to over €550 million with €400 million of that going on nursing home care. Up to 75% of stroke victims never go back to work and there are major difficulties for them and their families. When the HSE, Health Service Executive, launched the national stroke programme four years ago, the death rate from strokes fell by 13% while the rate of discharge of patients from hospitals to nursing home care was down 28%. The savings from the reduced requirement for nursing home care are conservatively estimated at €22 million. These are positive results which came about because the HSE invested in a stroke network and took account of reports that stated better acute stroke services would save lives and money on a significant scale.

Better community rehabilitation services can maximise recovery, however. I acknowledge the work of the Irish Heart Foundation and its research in this area. Up to 44% of all stroke sufferers, more than 3,000 people every year, are in the mild to moderate stroke category. They could benefit from early supported discharge programmes. The idea is to get them home earlier. The Government’s health policy in many areas is about getting people back to their families and communities. We are very much in favour of that with mental health issues. This would be particularly valuable also in the stroke rehabilitation area. It is estimated that €12 million could be saved by such a move and it would free up 24,000 hospital bed days which are in demand. It is expected that an initial outlay of between €5 million to €10 million would be the annual cost to resource community therapy and services to stroke victims. The cost to implement this would be considerably less than the cost of inpatient stay. With so much going into nursing home care, those in the mild to moderate range are losing out when they leave hospital because they need physiotherapy, occupational and speech and language therapy. It would be better for them to be at home where they would have services and a greater delivery of care in the community.

The 2014 Irish Heart Foundation, Economic and Research Institute of Ireland, ESRI, and the Royal College of Surgeons in Ireland, RCSI, report stated:

Clinicians engaged in stroke care in 24 out of 28 acute hospitals agree that inadequacies in community services lead to referrals of patients post-discharge for rehabilitation services in hospitals or other inpatient locations such as nursing homes, who could be treated at home by community services if these were more readily available.

Nursing home costs would be reduced if more stroke patients were able to live independently at home. I hope there will be a positive response to a small outlay of funding to bring this about even on a pilot scheme to show it will work.

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