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

Nobody is denying the progress that has been made. However, there is a real fear that that progress is being undermined. There is somewhat a discrepancy between the facts provided in the Minister of State's answer and what we heard last week in the AV room. There must be action around the rehabilitation services. As the Minister of State said, more people than ever are living and not dying following strokes, but they are living with the aftereffects of strokes. More lives are being saved because of the improvements in the acute services. However, the therapy to ensure quality of life is missing. The physical, psychological and communication services are available to those with private insurance.

The rate of the return home of stroke patients is falling. Returning home is more beneficial personally and costs less, but the services have to be there to ensure that. We need to look at the way the money is spent. Immediate treatment in hospital, rehabilitation in the community and home care mean less reliance on nursing home care. There is research from the Irish Heart Foundation on the cost of stroke. Out of a direct cost to the State of up to €557 million per annum, as much as €414 million is spent on long-term care for stroke patients. Less than €7 million is spent on community rehabilitation programmes that help people remain at home.

I want to quote from an advocate whose family have suffered strokes. He said: "Tonight hundreds of people will sit down to dinner with their families because of service improvements delivered by stroke teams in every corner of the country in the last six years but a great deal more will not be in their own homes but forced to live away from their families in long-term care because we ultimately did not do enough for them." He is just asking that we look again at how the money is being spent to ensure people do not have to go into long-term nursing care but can go home.

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