Jan O'Sullivan (Limerick East, Labour)
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I welcome the opportunity to raise the need for the Minister for Health and Children to appoint a neurologist with support staff to the mid-western regional hospital. This is a matter of urgency because the visiting neurologist no longer accepts new patients. I also welcome the fact that the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, is in the House tonight because he will share my concern about this matter. We both served on the former Mid-Western Health Board when this issue was raised many times over the years.

This issue is vital to thousands of people in the mid-west region who suffer from neurological conditions such as multiple sclerosis, Parkinson's disease and many other conditions. The situation is woefully inadequate and very distressing for patients. General practitioners have been instructed to refer new patients to Dublin, Cork or Galway. A circular is sent around when GPs attempt to refer patients to the limited service that exists in the mid west. It states:

The following is the current position regarding the neurology services at the Mid-Western Regional Hospital, Dooradoyle, Limerick. At present the Mid-Western Regional Hospital has the services of a visiting consultant neurologist for two days per month. This consultant provides an outpatient service for review return patients and an inpatient consultation service only. The waiting list for neurological assessment has grown substantially and waiting times for routine appointments of several years are not uncommon. Due to pressure on the existing service, I regret to inform you that the hospital cannot accept further new patient referrals. The neurologist will continue to see review patients and draw patients from the review waiting list as it stands, but I would advise that new patient referrals should be forwarded to the GPs' neurological services at Cork, Galway and Dublin.

Please note that any patient seen within the last two years will be seen as a return patient. However, if the interval is greater than two years the patient will be regarded as a new referral. It is with great regret that this action continues to be taken but the current volume of work is not sustainable within the existing consultant staffing levels.

That circular has been in place for at least two years but the hospital continues to send it out whenever a GP tries to refer a patient to the services.

The Minister of State and I were members of the then Mid-Western Health Board when it made recommendations on this matter in 1999 and 2003. The Comhairle na nOspidéal report on neurology and neurophysiology of April 2003 recommended that a post be developed in Limerick. The national task force on medical staffing recommended further neurological posts in the country.

I have raised this issue by way of parliamentary question at least three times and we are still waiting for a most essential service in the mid-western region. It is not a question of wanting a specialty in every hospital but it has been recommended by national bodies set up to make such recommendations. It is not acceptable that we have waited so long for this important appointment. The experience of patients, many of whom have chronic illnesses, is distressing because they expect to be treated in their own region but instead must travel for treatment.

On a separate issue, people in the mid west are deeply concerned that they no longer seem to have the same priority as neighbouring regions in regard to the siting of major health specialties and services. For example, breast screening will be run from Cork and Galway and radiotherapy services were provided only after local fund-raising for them, otherwise people would have had to go to other regions for the services. The region is no longer autonomous in respect of health services. The health centre for the mid west is in Galway, and all meetings are held there rather than in Limerick. The area is losing out on many health services. I wish to ensure the area does not lose out further but gets a neurologist and neurological team without delay.

Tim O'Malley (Limerick East, Progressive Democrats)
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I am taking this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. As Deputy O'Sullivan stated, she and I lobbied for years while we were on the former Mid-Western Health Board for the provision of neurology services in the mid west.

As part of the Estimates for the health services in 2006, additional funding of €3 million was allocated to the Health Service Executive specifically for the further development of neurology and neurophysiology services nationally. This funding was provided to allow the Health Service Executive to further progress the implementation of the recommendations made by the former Comhairle na nOspidéal in respect of these services. The Comhairle report of the committee to review neurology and neurophysiology services recommended significant enhancement of services, including the appointment of additional consultants. While reaching the full complement of consultant posts as recommended will take some time, major improvements in patient care can be achieved in the short term through a combination of additional consultant posts and the appointment of a number of clinical nurse specialists and allied health professionals.

A priority objective for the National Hospitals Office is to progress the implementation of the Comhairle report to address immediate service needs and to improve equity of access in the regions. This Department has been advised by the Health Service Executive that the development of three new neurology units will commence during 2006, one in the mid west, one in the north west and one in the south east, with the appointment of multidisciplinary teams comprising consultant neurologists and support staff.

The mid-western regional hospital has the services of a visiting consultant neurologist two days per month. The consultant provides an out-patient service for review or return patients and an inpatient consultation service. Due to pressure on the existing service, new patient referrals are forwarded to the neurological services at Cork, Galway or Dublin. ln view of the pressures, the development of neurology services at the mid-western regional hospital is an urgent priority for the Health Service Executive in 2006.

This Government is committed to the continued development of neurology services nationally. Resources have been made available to commence neurology services in Limerick and I am confident that the Health Service Executive will succeed in its objective to deliver these important services in 2006.