Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I thank the Deputy for providing me with the opportunity to speak on the subject of strokes. I am replying to this debate on behalf of my colleague, the Minister for Health, Deputy Simon Harris, and I am sorry that he cannot be here.

The aim of the HSE national clinical programme for stroke is to improve the quality, access and cost-effectiveness of stroke services in Ireland. Since the commencement of this programme, nine new stroke units have opened, bringing the total number of stroke units to 21. This represents good progress from the single unit that was available in 2008. I would like to draw the attention of the House to the national stroke audit which was published last year and pointed to encouraging improvement in many areas of stroke care. Specifically, the audit identified that inpatient mortality has reduced and discharges directed to nursing homes have reduced, and this has been matched with an increase in patients who are discharged directly home after a stroke.

The second national stroke audit emphasises the role of a stroke unit in a hospital. It reported that the provision of care in a stroke unit is supported by the evidence, reducing morbidity and mortality. Therefore, it is suggested that all sites managing acute patients should provide stroke unit care and all sites should develop their stroke units to provide the highest possible quality of care, including ensuring units are appropriately staffed, equipped and provide ongoing education and training for staff, patients and carers alike.

I am advised by the HSE that 24-7 access to safe stroke thrombolysis is available nationally. It is also worth noting that our current thrombolysis rate of 11.6% exceeds the national target of 9% and is among the best in national rates worldwide. I appreciate the Deputy's particular interest in University Hospital Kerry and the absence of a dedicated stroke unit at that hospital. I am advised by the hospital that recruitment and retention of the required staff is proving to be challenging. However, I understand that the business cases have been prepared for additional support staff, such that a stroke unit may be established.

These business cases will be considered by the South/South West Hospitals Group in the first instance and then by the HSE acute hospital division.

I am also advised that the case for a further geriatrician for the hospital has been referred to the consultant applications advisory committee for consideration. While there is no dedicated stroke unit at the hospital, I have been assured procedures are in place such that stroke patients can continue to receive treatment within hospital. Solutions are being sought across the hospital group to address the current situation. In that regard, the clinical needs of a patient will always be the determining factor, so patients will be transferred to tertiary hospitals if the need arises.

I accept that the Deputy will be disappointed that I cannot be more definite about the timescale for the establishment of a stroke unit at the hospital. However, the roll-out of stroke units is a work in progress and I thank him for drawing the particular need in Kerry to my attention.

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