Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

Before I respond to Deputy Maureen O'Sullivan, I warmly welcome the agreement between Vertex, the HSE and the Government on the drugs for treating cystic fibrosis. I want to commend all those involved, including the Minister, the cystic fibrosis families and Ms Rebecca Hunt from Vertex, who did a lot of work on this issue as well. I just want to wish everybody well because it is a good day for cystic fibrosis families and a good day for the health service.

With regard to this Topical Issue, I am very grateful to Deputy Maureen O'Sullivan for providing me with the welcome opportunity to talk about stroke services in Ireland. Let me start by referring to the good work of the HSE national clinical programme for stroke. The national clinical programme for stroke has been in place since early 2010. The vision of the programme is to design standardised models of integrated care pathways for the delivery of clinical care to ensure sustained quality clinical operational management. Overall, the programme aims to improve the quality, access and cost-effectiveness of stroke services in Ireland. The programme can point to many improvements in stroke care since its inception. The HSE has previously advised my Department that emergency thrombolysis is now provided to patients in all regions through improved hospital and ambulance protocols, health professional training and the appointment of new physicians. There is national 24-7 access to safe stroke thrombolysis, the rate of which has increased from 1% in 2006 to a current rate of 13%. This exceeds the national target of 9%.

Access to stroke unit care has been shown to improve stroke patient outcomes through reduced mortality rates, reduced dependency and shorter lengths of stay in hospital for patients. Since the commencement of the national clinical programme for stroke, nine new stroke units have been opened, bringing the total number of stroke units in acute hospitals to 22. This is a major improvement on the first national stroke care audit in 2006, which reported one stroke unit in the country. The programme has also developed a range of care pathways to assist the streamlining and standardisation of stroke care delivery. The cost objectives of the programme have also been met with more stroke patients experiencing improved clinical outcomes. Examples include: fewer stroke patients are dying in hospital - the rate dropped from 16.2% in 2009 to 14.1% in 2014, an overall percentage reduction of 12.9%; fewer stroke patients are discharged to nursing homes and, therefore, there are improved disability outcomes - this decreased from 17.7% in 2009 to 13.8% in 2014, an overall percentage reduction of 22.1%; more stroke patients are discharged directly to home from acute hospitals - the rate increased from 50.7% in 2009 to 51.6% in 2014; and the median acute hospital length of stay for stroke fell from ten days in 2009 to nine days in 2014, with an estimated 19,000 bed days saved in the 2011 to 2014 period. This is all good news for stroke patients. However, I accept Deputy Maureen O'Sullivan's point that we have to do more and that more has to be done.

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