Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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16. To ask the Minister for Health his plans to address the absence of a dedicated specialist medical rehabilitation unit for persons with neurological disabilities in the south [12347/17]

Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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What are the Minister for Health's plans to address the absence of a dedicated specialist medical rehabilitation unit for persons with neurological disabilities in the south of the country?

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Murphy O'Mahony for raising this very important issue of neurological disabilities in the south.

The Health Service Executive's national service plan for 2017 contains a priority to finalise and progress implementation of the framework for the neuro-rehabilitation strategy.

Full implementation of the strategy will, of necessity, be a long-term project. The Department of Health has agreed with the HSE that the focus initially will be on implementation in the community, which is in keeping with the programme for Government commitment.

The HSE has committed to undertake a mapping and gap identification exercise for the country as a whole in order to establish a clear picture of where specialist rehabilitation services are being delivered and where demands for such services exist. The HSE's social care division and the rehabilitation medicine clinical programme will work together to form an action plan under the HSE's clinical strategy and programme division. A national steering group, which, importantly, will comprise stakeholders who represent all interested parties, will be responsible for the governance and implementation of the action plan.

The priority capital development at present is the delivery of replacement accommodation at the National Rehabilitation Hospital. The procurement of a contractor has commenced. It is projected that a contractor will be appointed in the second quarter of 2017.

It is acknowledged that further investment in rehabilitation services at acute hospital and post-acute and community levels is required to meet the ongoing needs of clients across the country, including in the south.

I understand the HSE's South/South West hospital group is considering the scope for developing regional specialist rehabilitation services in the south in line with the national model of care for the provision of rehabilitative medicine and the neuro-rehabilitation strategy. A group led by a UK-based consultant in rehabilitation medicine has been established by the hospital group to consider this issue. A report is expected to be completed later in 2017.

Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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As the Minister of State is aware, there is a severe shortage of rehabilitation services in the Irish health care system for people living with neurological conditions such as stroke, acquired brain injury, multiple sclerosis and Parkinson's disease. It has been estimated that Ireland should have 270 inpatient beds to meet the needs of its population in this regard, but it has less than half of that number. There are no such beds outside Dublin. Numerous reports have highlighted the critical need to provide a dedicated specialist rehabilitation unit to serve the needs of people in the south of our country. Patients from the south represent one in four referrals to the National Rehabilitation Hospital. Individual reports in 2000, 2003, 2007, 2008 and 2011 pointed to the need for a special medical rehabilitation service to meet the needs of people with neurological conditions in Cork and Kerry. One of the many recommendations made in the report on the configuration of acute hospital services in Cork and Kerry, which was published by the HSE in 2011, was that a consultant in rehabilitation medicine, shared between the HSE south and the National Rehabilitation Hospital, should be appointed. The report also recommended that there should be a new regional rehabilitation medicine service with formal links to the National Rehabilitation Hospital and a named clinical lead. I ask the Minister of State to comment on what I have said.

Finian McGrath (Dublin Bay North, Independent)
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I accept the Deputy's point about the importance of investing in these services. I also take her point about the objective of having 270 beds. This is a priority for me because we have to meet the needs of the people. One of the priority actions in the HSE national service plan for 2017 is the establishment of an innovative pilot day service aimed at supporting people with severe acquired brain injuries. The inclusion of this action was informed by the meetings between the Minister for Health, the Department of Health and the HSE and the representatives of the An Saol project, for example. The head of operations in the HSE disability service wrote recently to a representative of the project to confirm that approval has been given for the progression in 2017 of a pilot initiative that will focus on the provision of therapies for people with severe acquired brain injuries. It is important to note that the HSE funds a large range of services across the country, including acute hospital services, the National Rehabilitation Hospital, a range of multidisciplinary services, a range of assisted living supports and rehabilitation training services. Of course, we must accept that this issue needs to be dealt with. The Minister, Deputy Harris, and I have made this a major priority for 2017.

Margaret Murphy O'Mahony (Cork South West, Fianna Fail)
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The programme for Government includes a commitment to publish an implementation plan for the development of neuro-rehabilitation services in the community. Will the Minister of State give the House a commitment that the plan will provide what has been recommended for the south? In his initial response, he used the word "considering", which is really not strong enough. A firm commitment is needed. The 2011 report clearly highlighted that Cork and Kerry need an acute rehabilitation medicine service that can provide a post-acute specialist rehabilitation service for acquired brain injury and neurological diagnosis to people between the ages of 18 and 65. The report argued that this service should be led by a consultant in rehabilitation medicine linked to the National Rehabilitation Hospital in Dublin and supported by a regional rehabilitation co-ordinator and a multidisciplinary professional team, including a clinical neuropsychologist. The report specifically highlighted that the presence of specialists in rehabilitation medicine would be of considerable benefit to the health service in Cork and Kerry.

Finian McGrath (Dublin Bay North, Independent)
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We have to ensure that services are not just focused in one or two regions. We need to have a national service. I take the Deputy's point about the implementation of the plan for Cork and Kerry. It is important to note that although Acquired Brain Injury Ireland works mainly with adults between the ages of 18 and 65 whose main disability is an acquired brain injury, it is also involved in the development of pilot projects providing services for children and runs parenting programmes in Dublin for the parents of children with acquired brain injuries. Headway Ireland provides a range of services to people with acquired injury between the ages of 16 and 65, including day services, psychology and social work services, community integration programmes, employment and family supports and rehabilitation training places. It is important for further investment in rehabilitation services to be considered in the context of the overall acute hospital rehabilitation medicine infrastructure programme. The needs of the hospital group will be prioritised within the overall capital envelope available to the health service. Such issues are important. The Department of Health will work with the HSE and the Department of Public Expenditure and Reform during 2017 to conduct a mid-term review of the capital programme.