Dáil debates

Wednesday, 6 July 2011

9:00 pm

Photo of Brendan GriffinBrendan Griffin (Kerry South, Fine Gael)
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Recently I had the opportunity to visit the acquired brain injury rehabilitation centre in Castleisland, County Kerry, which is administered by Acquired Brain Injury Ireland. The visit was an eye-opener. I have some experience of acquired brain injury in my family, but the visit will stay with me. Many of those attending the centre have been the victims of road or various other accidents or are people who got sick as a result of various infections or viruses, etc. which resulted in acquired brain injury. The service being provided in Castleisland is fantastic. It is the proper model for dealing with people with acquired brain injury and to help them to be rehabilitated and live as independent a life as possible. The service is run by fantastic professionals who do a wonderful job in which they are supported by the HSE, Kerry County Council and other agencies.

One major issue is the great stigma attached to acquired brain injury. People to whom I spoke at the centre took the view that the stigma of disability was attached to them. Rather than being seen as people with disabilities, they would prefer to be seen as people in rehabilitation.

Sadly, not everyone who acquires a brain injury in Ireland has the opportunity to avail of rehabilitation services. That is why I raise this important issue tonight. We must change our approach to the way we deal with ABI. We must ensure everyone who suffers a brain injury is given the opportunity to be rehabilitated. Some 10,000 people acquire a brain injury in Ireland every year, but only one in four get into the National Rehabilitation Hospital. This means some 7,500 do not get into the hospital. I realise there are other forms of rehabilitation and that other services are provided for those who acquire a brain injury. However, we must adopt a more community-focused approach. That is what I seek in the lifetime of the Government.

Some of the ABI injuries which I have encountered and of which I have been made aware by the professionals working in the field could have been prevented. The need for cyclists to wear helmets has been highlighted to me. It is simple, but many of those who suffer an ABI in Ireland every year are cyclists who fall off their bicycles or are involved in road traffic collisions. We must try to tackle this issue. It is a small simple matter but significant nonetheless and we must consider it.

The implementation of the national policy on and strategy for the provision of neuro-rehabilitation services in Ireland will make a difference, as the professionals working in the field are aware. The ABI model should be extended, where possible, but funding must also be made available. There must be understanding in the community and a focus on this model. That has not happened to date as much as we would have wished.

I would be grateful if the Minister of State gave this issue her attention during her tenure. This is an important matter and the numbers affected are considerable, some 10,000 people every year. We could start by trying to address the problem of stigma attached to ABI and proceed from there. Those who run the service are keen to help more people to help themselves, but they need support to do so. I hope the Minister of State will be in a position to deliver it.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I am pleased to take the opportunity to outline the position on the matter raised by the Deputy which I thank him for raising.

The aim of rehabilitation is to enable the person to achieve the highest possible level of independence. Desired outcomes range from a return to full independence in social and work activities to a person requiring long-term support and care but with a higher level of independence than in the absence of rehabilitation. Current services available to persons with an acquired brain injury, ABI, include: acute hospital services; the National Rehabilitation Hospital; multi-disciplinary community services; long-term assisted living supports; and rehabilitative training services. These services are provided directly by the HSE and several non-statutory organisations.

Within disability services, the two main organisations funded to meet the needs of service users with an ABI nationally are Acquired Brain Injury Ireland and Headway Ireland. Acquired Brain Injury Ireland works in partnership with the HSE to provide a range of flexible and tailor-made services for people with an acquired brain injury in direct response to local identified needs. Services provided by Acquired Brain Injury Ireland nationwide include: 14 assisted living services; home and community rehabilitation and outreach services; day resource services; family support services, home liaison and social work; psychological services; and acquired brain injury awareness information, training and education programmes. In partnership with the HSE, Headway Ireland provides a range of services to people with an ABI. The services include day services, psychology and social work services, community integration programmes, supported employment, family support and rehabilitation training programmes.

Acquired Brain Injury Ireland received funding of €8.011 million in 2010, while Headway Ireland received funding amounting to €2.65 million in the same year. Both the Department of Health and the HSE have recognised for some time the need to develop comprehensive and integrated rehabilitation services. The Department of Health and the HSE have developed a national policy and strategy for the provision of neuro-rehabilitation services. The Department hopes to publish the strategy soon. The report recognises that given the current economic climate, the focus in the short to medium term must be on reconfiguration of services, structures and resources and the enhancement of the skills and competencies. Implementation of the neuro-rehabilitation strategy will require both an executive and a clinical lead who will work jointly at a national level to progress the implementation. To support the recommendations contained in the report, the HSE national service plan for 2011 includes a commitment to appoint a national clinical lead for rehabilitation to develop an implementation plan and an implementation structure for the provision of neuro-rehabilitation services. Implementation will have a particular focus on the development of a range of integrated services at regional and local level and to ensure regions have the capacity to respond to local needs. As part of its development of clinical care programmes, the quality and clinical care directorate of the HSE has established a rehabilitation medicine programme. This programme will improve and standardise patient care throughout the organisation by bringing together clinical disciplines and enabling them to share innovative solutions to deliver greater benefits to all users of HSE services.

The work of the rehabilitation medicine programme will be to achieve three main objectives, namely, to improve the quality of care, to improve access to services and to improve cost effectiveness. The HSE has appointed a clinical lead who will have responsibility for both the rehabilitation medicine programme and the implementation of the neuro-rehabilitation strategy. The appointment of a single clinical lead for both interrelated programmes will help to improve service quality, effectiveness and service user access and will ensure patient care is provided in the service setting most appropriate to the individual's needs. I again thank the Deputy for raising this issue, in which I have a deep personal interest.