Brian Stanley (Laois, Sinn Fein)
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I welcome the opportunity to raise this issue and that the Minister of State, Deputy Finian McGrath, is in the Chamber to take this debate.

Finian McGrath (Dublin Bay North, Independent)
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I am always here for my Topical Issue matters.

Brian Stanley (Laois, Sinn Fein)
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We met representatives of Acquired Brain Injury Ireland, ABI Ireland, last week when they gave a presentation to Oireachtas Members and staff. The excellent presentation outlined the scale of what we are dealing with in Ireland and what is needed to provide a proper response. ABI Ireland estimates that 19,000 people acquire a brain injury each year. These injuries can be caused by strokes, accidents, tumours, assaults and illnesses. Approximately 100,000 people have brain injuries. I understand ABI Ireland is a section 39 organisation providing vital services to those living with a brain injury, a type of injury that has a major impact on people's lives and can leave some people completely disabled.

The National Rehabilitation Hospital, NRH, in Dún Laoghaire is doing excellent work. Many people who have gone through the unit have made excellent progress. We all know such people in our communities. Some of them have made almost a full recovery and returned to normal life. More capacity is needed in the system, however. ABI Ireland provides neuro-rehabilitation community services that complement and sometimes replace full-time residential care and rehabilitation. It ensures that people can make a seamless move home from a hospital or permanent setting, such as the NRH. This avoids lengthy stays in hospital and, importantly, maximises the chances of a good recovery.

ABI Ireland needs funding. Its current model is not secure or sufficient to meet the scale of its operations. It has to seek funding from the HSE every month to keep going. The organisation is pleading for money to stay afloat. That is not good enough. ABI Ireland requires further core funding of €1.5 million per annum to maintain its services and meet growing demand. The population is expanding, which places increased demand on ABI Ireland because the number of strokes and accidents is also increasing.

There are no specialist beds for acquired brain injuries outside Dublin and rehabilitation services in general are under-resourced. ABI Ireland wants to establish a regional neurological rehabilitation centre to provide inpatient and outpatient rehabilitation. This could be based in the midlands, for example, where it would be within easy reach of all parts of the country. ABI Ireland plans to build a 25-bed unit for which once-off development funding of €5 million would be needed to kick-start the project. People could then avail of this regional service instead of being moved from hospitals to nursing homes. ABI Ireland faces two key funding pressures. One is core funding to keep going and the other is securing the €5 million in seed capital it needs to kick-start the development of a regional centre providing important inpatient and outpatient rehabilitation services.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Stanley for raising this important issue and offering me the opportunity to respond to the House today. The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in A Programme for Partnership Government, which is guided by two principles, namely, equality of opportunity and improving the quality of life for people with disabilities. Acquired Brain Injury Ireland is, as Deputy Stanley stated, a section 39 voluntary organisation which was set up in June 2000 in response to the need for services for people with an acquired brain injury. ABI Ireland aims to enable people with an acquired brain injury to live an independent life in the community by providing and maintaining a supportive living environment. I strongly support its work and I work closely with it.

The HSE funds a range of services across the country for people with acquired brain injury. These services include acute hospital services, the National Rehabilitation Hospital and a range of multidisciplinary services at local level providing rehabilitation in the community to people with acquired brain injury. The HSE also funds a range of long-term assisted living supports, usually contracted by the health service from the non-statutory sector, and rehabilitative training services, which are also usually contracted by the health service from the non-statutory sector. ABI Ireland works in partnership with the HSE to provide a range of flexible and tailor-made services for people with acquired brain injury in direct response to local identified needs. Services provided by ABI Ireland nationwide include 14 assisted living services, home and community rehabilitation and outreach services, day resource services, family support services, home liaison, social work and psychological services and acquired brain injury awareness information training and education programmes.

Turning to the development of neuro-rehabilitation facilities, the national neuro-rehabilitation policy and strategy implementation framework 2019-21 was published by the HSE in February this year. This policy will guide the roll-out and implementation of the national neuro-rehabilitation strategy in the years to come. Discussions are ongoing on the identification of the funding required to implement the framework. That is what is happening at the moment.

While the implementation framework will support the delivery of services to persons with acquired brain injury, it does not concentrate on any one specific diagnosis and aims to reach all people with neuro-rehabilitation requirements. ABI Ireland is funded

under section 39 of the Health Act, as Deputy Stanley mentioned, and is subject to service arrangements. The organisation is scheduled to receive funding from the HSE of €12.6 million in 2019. The HSE and I recognise the value of ABI Ireland's services to people with acquired brain injury. However, further increases in funding can only be considered within the parameters and scope of funding available to the HSE. In the weeks since the budget, we negotiated a HSE service plan with funding of approximately €2 billion. Negotiations are ongoing and in that regard I will take on board the Deputy's proposals because I value the work of ABI Ireland.

Brian Stanley (Laois, Sinn Fein)
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I thank the Minister of State for his reply. I note his point in respect of co-operation and partnership between the HSE and ABI Ireland. I do not dispute that. The case being made by ABI Ireland is that its funding is stretched. Its budget is approximately €13 million and HSE funding for ongoing operational costs this year will amount to €12 million. ABI Ireland is a significant organisation. This country's record on rehabilitative care has been weak, regardless of the injury or illness involved. The Minister of State takes a special interest in these matters and he knows that when people get timely interventions after an accident or a serious medical issue, such as a stroke, the long-term benefits for the individual and his or her family and community are immense. In many cases, it enables the person to return to work. I know several people who had brain injuries and have returned to work.

In fact, both of those who gave the presentation here that day, Niamh from my constituency and Ian from Dublin, are working in jobs every day now and they had gone through significant trauma. That tells me the need for us to concentrate on this. It is money well spent.

Notwithstanding that funding is being provided and there is a partnership, I ask the Minister of State to ask the Minister for Health to look again at the organisation's core funding to see if anything can be done to help it out, and to give consideration to the concept of establishing a regional neurological rehabilitation centre and service that would provide both inpatient and outpatient services to those suffering from an acquired brain injury. I ask the Minister of State to take back those two messages and to liaise with Acquired Brain Injury Ireland on that.

Finian McGrath (Dublin Bay North, Independent)
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As I set out earlier, the HSE recognises the value of the Acquired Brain Injury Ireland service to those with acquired brain injury, ABI. That is the first point. Further increases in funding can only be considered within the parameters and scope of funding available to the HSE. That debate is now going on. As the Deputy correctly said, ABII received €12.6 million in funding from the HSE. The Deputy put forward a number of proposals. I take his point and accept his argument on the stability of funding because I am aware, from working with ABII, that that is an issue.

I agree 100% with the Deputy's point on timely interventions. The quicker people can come through the fantastic service the organisation has and back into the workforce, the better. It is making a contribution to society. Those are the points that I will be making on the HSE service plan.

ABII is also represented on the neuro-rehabilitation national steering group through the executive director of the Neurological Alliance of Ireland. It also has a seat on the working group tasked with developing the implementation framework and on the managed clinical rehabilitation network demonstrator working group. It is in those key positions.

I am informed by the HSE that work is continuing on progressing a number of key areas that will underpin the success and evaluation of a managed clinical rehabilitation network. The executive's national service plan, which will set out the detail of the level of service and supports that will be provided in 2020, is currently being agreed.

I absolutely take on board the issue. If we come at it from both sides, the Deputy's side where they have representatives on the steering groups and my side, we can see if we can push out, so to speak, the valid request for an increase in neuro-rehabilitation. As far as I am concerned, ABI Ireland makes a significant contribution to the country. As Minister of State with responsibility for disabilities, I am convinced when I see many people who had a disability all of a sudden back in their work, using their ability, making a contribution and paying taxes such as PAYE. That is positive. It is also a good long-term health policy.