Danny Healy-Rae (Kerry, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Leas-Cheann Comhairle for allowing me to highlight Parkinson's disease and the need for services for those who have developed this disease and especially for the carers and family members who have to help them. Parkinson's is a progressive neurological disorder caused by the shortage of the chemical dopamine in the brain. The diagnosis of a serious movement disorder can be very challenging. It presents those affected with numerous emotions and obstacles and a combination of solutions are required, including care, support and information. The management of common chronic diseases, such as Parkinson's, is now one of the most significant challenges our health care system faces. It requires us to find ways of providing health care services to help patients and their families.

I hope that events such as this help to highlight the need for funding and services to be provided so that the patients can be partners in the management of their condition and cope better with it. We know of almost 12,000 patients in the country, and approximately 600 of these are in Kerry. In 2016, Dr. Richard Walsh, a consultant neurologist in Tallaght hospital, published a landmark Irish study on Parkinson's disease in partnership with the Parkinson's Association of Ireland. The study showed that the number of people living with the disease in Ireland is predicted to double over the next 20 years but treatment in Ireland is shamefully well below international standards.

Older people are some of the most vulnerable people in our society. We have a large population moving into advancing years and living longer, which would give rise to a surge in Parkinson's diagnoses over the next 20 to 30 years. It is critical that those of us in public life do our utmost to address the deficit in services for those with Parkinson's.

A significant issue facing those with Parkinson's disease is the number of Parkinson's nurse specialists in Ireland. We have five but the recommended number is between 27 and 30. I remind the Minister of State that three of those nurse specialists are in Dublin and the other two are for the remainder of the country. I ask the Minister of State to provide nursing specialists distributed fairly throughout the country. We should have two in Kerry but we are well entitled to have one.

Another issue is to secure an all Ireland deep brain stimulation service. Deep brain stimulation is a device-aided therapy involving an implant into the brain. The Oireachtas Joint Committee on Health reviewed this and recommended a link with Northern Ireland to provide the surgery, with the Mater hospital in Dublin providing aftercare. This would mean we would need more buses like those for people going for eye and cataract treatment in the North but so be it. Will the Minister of State provide these therapies which we need?

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Deputy Healy-Rae for raising this very important issue of support for sufferers of Parkinson's disease. It is estimated that 700,000 persons in Ireland are affected by neurological disease, 6,000 of whom have been diagnosed with Parkinson's disease.

Working in collaboration with consultants, nurses, health and social care professionals, patient support groups, patients and carers, the national clinical programme for neurology has developed a model of care to address the need for the strategic development of neurology services. The model of care, which was published in 2016, details a number of care pathways, one of which is the pathway for patients with Parkinson's disease.

The patient pathway for Parkinson's outlines that the nature and severity of the symptoms of Parkinson's disease and the rate at which it progresses will be individual. Symptoms may take years to progress to a point where they cause major problems. Drugs are the main treatment to help control the symptoms of Parkinson's disease. These treatments are most effective when supported by access to multidisciplinary input from health and social care professions.

With regard to nursing, the patient pathway also sets out the role of the clinical nurse specialist in the management of patients with Parkinson's disease. This includes assessing the person with Parkinson's disease and identifying their needs, developing care plans and monitoring symptoms as well as providing lifestyle support. As with all service developments, the implementation of the neurology model of care, including the Parkinson's patient pathway, will be addressed in the context of competing priorities for the limited service development funding.

The Health Service Executive funds a range of community services and supports to enable each individual with a disability, including persons with Parkinson's disease, to achieve their full potential and maximise independence, including living as independently as possible. Services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups. Services are provided either directly by the HSE or through a range of voluntary service providers. The range of services provided includes assisted living services such as personal assistant and home support services.

The Government is committed to protecting the level of personal assistant and home support services available to people with disabilities. In 2017, the HSE's priority is to provide 1.4 million hours of personal assistance to more than 2,000 people with disabilities, which is an increase of 100,000 hours over the 2016 target. In 2017, the HSE will also provide 2.75 million hours of home support to adults and children with disabilities, an increase of 150,000 hours over the 2016 target.

Therapy services for adults and children are generally delivered through primary care teams or community therapy services through specialist disability providers. People with disabilities may also be eligible for medical or surgical aids and assistive devices that facilitate and maintain mobility and functional independence. People with Parkinson's disease can benefit from therapeutic assistance, including physiotherapy, occupational therapy and speech and language therapy as well as a range of medical interventions.

I assure the Deputy that we are aware of the challenges facing people with Parkinson's disease and the Department of Health continues to work with the HSE to ensure the delivery of services to meet the needs of these patients. I will come back to the Deputy on some of the questions he has raised.

Danny Healy-Rae (Kerry, Independent)
Link to this: Individually | In context | Oireachtas source

Only 3% of Irish Parkinson's patients have access to deep brain stimulation, which is established as a standard treatment for patients with medication frequency issues. Therefore, the implementation of the neurorehabilitation strategy is critical to people with Parkinson's. This strategy was published in 2011 but there is still no implementation plan in place. There is a commitment in the programme for Government to publish an implementation plan, but investment will be critical and we need investment in this area. Ireland has less than half the number of rehabilitation beds that we need for our population. We have the lowest number of consultants in rehabilitation medicine in Europe. This is completely unacceptable.

With regard to Parkinson's nurse specialists, there are only five in the country and three of these are in Dublin. I ask the Minister of State to think about this. There is one in Limerick, one in Galway and three in Dublin. I ask the Minister of State to provide this service for all of the patients throughout the country on a fair basis. I am asking especially for Kerry. It is up to every Deputy to stand up for his or her own community. I am standing up for the people of Kerry and I thank those in the local branch of the Parkinson's association in Kerry. Its president is Grace McCrae, and Connie Dillon and Brenda Edmonds are also involved. Dr. Helena Moore, a neurologist in Tralee, does tremendous work for all of the Kerry patients who come to her.

This is a serious problem. These are people in trouble. It is not a reversible disease. Once someone presents with it, it progresses and get worse and worse day by day. I ask the Minister of State please to take this to the Government and work to ensure we get fair play for people who present with this disorder.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Deputy. With respect to the Deputy and his devotion to the people of Kerry, he is always in the Chamber speaking about his constituents. We all have constituents. I know how when people have Parkinson's it affects not only the individuals, but their families. In saying this, I am sorry some of the statistics do not cover Kerry in particular, about which the Deputy is speaking, and I will ask that further details can be given to the Deputy. I have taken note of the fact he has said there are only five nurse specialists in the country, with three of them in Dublin and two in the rest of the country. This is something that needs to be addressed.

With regard to deep brain stimulation, I was a member of the health committee for a long time. I remember being at two or three meetings where individuals who had undergone the procedure came before the committee.

I was really struck by the fact that many of these people came on so well after they had deep brain stimulation procedures. I will raise this matter with the Minister and ask him to come back to the Deputy on it. I have taken a number of other notes that I will decipher when I go back upstairs. I thank the Deputy again. I will raise all the issues he has brought to my attention with the Minister.

Danny Healy-Rae (Kerry, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I am sorry it has not been more centralised around County Kerry.

Danny Healy-Rae (Kerry, Independent)
Link to this: Individually | In context | Oireachtas source

It is said that we have 600 patients in County Kerry, but the figure could be as high as 800.