Michael Moynihan (Cork North West, Fianna Fail)
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According to newspaper reports, a recruitment ban means epilepsy units remain closed, even though 200 patients are on waiting lists. As epilepsy can be a life threatening illness, some of these individuals' lives are at risk. The two specialised units in question are crucial to assessing the appropriateness of epilepsy patients for surgery. They were closed, in spite of the fact that they were an intrinsic part of the HSE's draft national epilepsy care programme which was published in the spring of last year. The two units are located in Cork University Hospital and Beaumont Hospital in Dublin. Among their functions is identifying patients who may be suitable for surgery, diagnosis, observation, education and counselling. I have been contacted by a number of individuals on the waiting list and know some of them personally. They suffer from a debilitating illness.

I gather that the cost of upgrading the units is in the region of €900,000. I have to agree with Brainwave, the Irish epilepsy association, that it seems entirely illogical for the HSE to sanction the redevelopment of the monitoring units and then to decline to fund the staff required to make them operational. Beaumont Hospital was also to be the national epilepsy centre under the HSE's plans, but this development cannot proceed because the emergency monitoring unit is closed. It is expected that the facility in Cork University Hospital will open at some stage this year. However, we need more than an expectation because waiting lists continue to grow. We need a definite commitment on when the units will be staffed. This morning Professor Norman Delanty from Beaumont Hospital warned that he could not look after his patients properly and would be compelled to send them abroad for treatment unless the two units needed to monitor seizures were opened. He rightly pointed out that this would have obvious cost implications for the State.

It appears that the unit in Cork has not been informed that the unit in Beaumont Hospital is closed because it continues to refer patients to Dublin. I have been contacted by numerous people with epilepsy, including the parents of young children. They were repeatedly told that new units were about to come on stream to monitor their condition. I ask the Minister the reason the HSE is not taking a more proactive approach to providing staff in the light of the money already invested in these units.

James Reilly (Dublin North, Fine Gael)
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I thank the Deputy for raising this important issue. I am aware of the challenges people with epilepsy face in managing their conditions and fully acknowledge the need for the provision of a dedicated service for all epilepsy patients. The epilepsy monitoring units in Cork and Beaumont Hospital are being developed under the HSE's national epilepsy clinical programme. I understand epilepsy monitoring is only required for the most vulnerable patients who suffer the worst effects of epilepsy. The majority of patients will have their care needs met through other epilepsy services, including the newly established rapid access clinics in four centres, Cork and Beaumont Hospital among them. The epilepsy monitoring units will increase pre-surgical evaluation capacity for those patients who may benefit from complex but potentially curative surgery. This development is, therefore, a clear priority for the programme. Patients at these units will require 24-7 care. The staffing needs to enable the units to be safely opened have been identified.

It is important to point out that there is no ban on recruitment. The Government decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction, but the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so. The normal processes will apply to the HSE's decisions on the recruitment of the required staff in Cork and Beaumont Hospital.

In regard to the staffing of the epilepsy monitoring units, the HSE has advised that Beaumont Hospital and the HSE are working jointly to fill the posts necessary to support this service development. With regard to the position in Cork, the HSE has advised that the service plan for 2013 for Cork University Hospital will be finalised in the coming weeks and that the provision of additional staff for the epilepsy monitoring unit is being considered as part of that process.

Cork and Beaumont Hospital are two of the six regional centres identified by the epilepsy clinical care programme for the provision of specialist epilepsy services. It is the intention that services will be provided by a team of nurses and consultant neurologists working as a virtual national network supporting all acute and primary care locations. Rapid access clinics providing care for the broad cohort of patients with epilepsy have been developed at Beaumont Hospital, St James's Hospital, in Galway and Limerick. As 10.5 whole-time equivalent advanced nurse practitioners, ANPs, have been recruited to lead these clinics, a total of 12 ANPs are now in place across the four centres delivering services both on site and on an outreach basis. The outreach model is facilitated by the epilepsy electronic patient record system developed by the programme which allows the ANPs to access the necessary patient information at the outreach locations. For patients, the rapid access clinic model means faster access closer to home and improved continuity of care. It is delivering tangible improvements in patient access and experience. I am committed to providing the best possible health service and will continue to work with the HSE to ensure the best outcomes for these patients.

Michael Moynihan (Cork North West, Fianna Fail)
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The Minister has stated the HSE is finalising its plans for the centres. I ask him to apply the same urgency to this matter as he did to the issues discussed earlier in regard to Kilkenny and Wexford hospitals. He will need to take a hands-on approach because people are suffering from epilepsy and young children are unable to access the full spectrum of services they need. I ask him to ensure the units are fully funded and operational because they are necessary for those who suffer from or have been diagnosed with epilepsy.

James Reilly (Dublin North, Fine Gael)
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I respect the Deputy's interest in this area, one in which I have considerable experience as a GP. I was attached to St. Ita's Hospital where many of the patients in the intellectual disability service had this problem. I realise how much it limits people's lives and interferes with their ability to work and understand that, above all else, good control of the condition can lead to quality of life, while poor control can destroy the quality of somebody's life. I will endeavour in every way I can to expedite the provision of this important service. However, I know this has been an issue for some time. I also know that the Deputy was part of the last Government at a time of plenty and the issue was not addressed then. While I will do everything I can with the limited resources I have available, it is only right to remind Members that when Fianna Fáil was in power, the issue was not addressed.