Thursday, 1 December 2016
When will the Minister for Health publish a plan for advancing neuro-rehabilitation services in the community? By any stretch of the imagination, when we consider the level of service available to people with stroke, acquired brain injury, multiple sclerosis and Parkinson's disease, we are light years away from what is necessary. In the context of a capital development plan next year, the assessment of the number of beds that will be required is also a key area that should be taken into account in the bed capacity review.
A Programme for a Partnership Government includes a commitment to publish "a plan for advancing neuro-rehabilitation services in the community."
It is recognised that the situation with regard to accessing specialist neuro-rehabilitation services needs to be reviewed. Significant steps towards finding a resolution were taken with the publication in 2011 of thenational policy and strategy for the provision of neuro-rehabilitation services Ireland 2011-2015. The rehabilitation medicine programme has also been developed within the clinical strategy and programmes directorate of the Health Service Executive, HSE
A national steering group, chaired by the head of the HSE’s disability reform team, has completed an implementation framework in respect of the recommendations from the national policy and strategy. Membership of this group includes representation from the HSE national clinical programmes for rehabilitation medicine and neurology, HSE primary care, the Department of Health, therapy professions and the Neurological Alliance of Ireland. The group is currently considering feedback on the framework, which was circulated to wider stakeholder interest groups. The HSE intends to finalise and progress implementation of the framework for the neuro-rehabilitation strategy in 2017.
In addition, capital funding is committed for the redevelopment of the National Rehabilitation Hospital in Dún Laoghaire. This funding will provide a new purpose-built 120-bed hospital with integrated therapy and support services at the Dún Laoghaire campus. It is expected that construction will commence in 2017.
The Minister of State is aware of the shortage but I want to put on the record that 25,000 people a year require some form of rehabilitative services. Most of them struggle just to get the basic services. Ireland should have 270 beds for its population but we have less than half that number, and none outside Dublin. We have been campaigning for a long time - in the context of rehabilitative support beds - for services to be located outside Dublin. There should be four regional inpatient specialist rehabilitation services but we have none. There are huge deficiencies in that regard and it is urgent that the matter be addressed.
Will the Minister of State outline the steps he is taking to ensure that the implementation plan for the national neuro-rehabilitation strategy will be fit for purpose and address the concerns of the Neurological Alliance of Ireland and its member organisations? Will he clarify whether new funding will be made available in 2017 to develop the neuro-rehabilitation services in the community? Will he outline the plans that are in place to invest in the development of neuro-rehabilitation services in acute hospitals in 2017, specifically in the South/South West Hospital Group? Following his commitment to publish the neuro-rehabilitation plan in the first quarter of next year, can he confirm that will still happen? Those are my questions. I do not expect the Minister of State to reply to them in full detail.
I will deal with all the questions. I totally accept that we have to develop services for people in those situations. I have met many of them. I spoke at one of the group's annual general meetings a few months ago so I am fully aware of the issues Deputy Kelleher has raised, which are very important. We need to improve and expand services but, as the Deputy knows, that work has commenced already. I mentioned the National Rehabilitation Hospital in Dún Laoghaire but there is also a new rehabilitation unit at Roscommon hospital, and other services are being rolled out throughout the country. The Minister and I have identified the provision of services throughout the country as an important issue in terms of developing the HSE service plan. We are doing our best to ensure that those type of services are developed.
The Minister recently met representatives of the Neurological Alliance of Ireland, who are members of the steering group, along with Councillor Natalie Treacy, whose mother has an acquired brain injury. We are very aware of the situation on the ground. We are aware also of the need to develop the services. We have started on that but we need to do more, which we will do in 2017.
Could I press the Minister of State on a date for the implementation plan? He mentioned my colleague, Councillor Natalie Treacy, and the Neurological Alliance of Ireland. Sinn Féin fully supports the We Need Our Heads Examined campaign but we need a date by which we will start seeing some movement on this issue and also confirmation that dedicated funding will be allocated, and what that funding will run to. With regard to the new unit at Roscommon hospital, how many beds is it anticipated will be provided? How many hours of rehabilitative care will be provided in the unit?
On the objectives and the funding, those are already included in the HSE service plan, which is currently being finalised. We will put a priority on that. I would see us start to move on developing, opening and investing in new services as early as possible in 2017. I will have to revert to the Deputy on the number of beds involved because it is important I give her accurate information.
I have asked the questions and I thank the Minister of State for the answers but the broader issue is that there must be some regional development of services. We cannot have them located in just one area of the country, which puts huge pressure on families that have to travel long distances over a protracted period. Many families do not have much hope that their loved ones will even get access to services and that debilitates them. I ask the Minister to bring forward the implementation plan as quickly as possible. We will try to support him in getting resources to ensure they have a meaningful impact on people's quality of life.
I take Deputy Kelleher's point that we need to develop services in the regions. As I mentioned earlier, the new rehabilitation unit at Roscommon hospital is a major start.
We must ensure that we support these families. They are in a difficult position and we cannot have them travelling for services in Dublin when they are from different parts of the country. We need to be radical. We need to work closely with the organisations that are putting forward these suggestions. We need to get working on this and implement as much as possible in 2017.