Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I thank the Minister of State for taking this Topical Issue matter. Since I was elected as a councillor in 2014, I have encountered strong, resilient people and families and have had the privilege of getting to know them. Many of those people have suffered acute brain injuries and spinal injuries resulting from farm and road accidents and so on. It is with admiration that I look upon both those people who have suffered those traumas and their families. It takes much work, not just medically but also mentally, to get people's lives back on track.

I have brought this Topical Issue matter to the floor of the House because a number of reviews and reports have been compiled since 2012 in relation to the South/South West Hospital Group. The group is responsible for approximately 1 million people in its catchment area across counties Cork, Kerry, Waterford and south Tipperary, more than 20% of our country's population, but, unfortunately, it has no access to the full range of rehabilitation services akin to what is provided in the National Rehabilitation Hospital in Dún Laoghaire. It is difficult to get a place in that rehabilitation centre, as the Minister of State knows. Many can be waiting for six to 12 months to get a place in that unit.

In 2017, Dr. Andrew Hanrahan undertook a review of rehabilitation services within the South/South West Hospital Group. A further review was taken in May 2019 and outlined the requirements for rehabilitation services in the area. In 2012, a regional specialist rehabilitation unit was first proposed for the South/South West Hospital Group to provide for patients with high to moderate intensity inpatient rehabilitation. This unit was to support patients with moderate to severe physical, cognitive or communicative disabilities, or a combination thereof. Services would be provided by trained rehabilitation staff and rehabilitation medicine consultants, supported by consultant neurologists. The review also recommended the development of a full range of rehabilitation services in the South/South West Hospital Group. That was in 2012.

We are now eight years on and I am asking that the Minister of State makes the aspiration a reality for the people of the south and the south west. I welcome, in response to a parliamentary question, a letter from Mr. Gerry O'Dwyer, chief executive officer of the South/South West Hospital Group. He stated that discussions are progressing about the development of a rehabilitation unit in Cork and an announcement will be made in the next few weeks. That is most welcome, especially for those families in Cork, Kerry, the Minister of State's native Waterford and south Tipperary who heretofore have been waiting up to 12 months for admission to the National Rehabilitation Hospital in Dún Laoghaire. People should be cared for in their own region, particularly in the context of Covid-19. It makes no sense that patients from the southern region would continue to travel to Dublin for specialist treatment that can be provided locally.

While I welcome the announcement that the rehabilitation unit is being progressed, I urge the Minister of State in the meantime to accede to requests made by consultants in Cork University Hospital for the provision of the required specialists who deal with trauma to be sanctioned. They are looking for additional rehabilitation consultants, speech and language therapists and physiotherapists, among other specialists. If this team could be put in place before the construction of a new rehabilitation unit, we could make a considerable difference to the lives of people who suffer from such debilitating diseases and serious traumas. There is currently an application with the HSE for the provision of that team, which is distinct from the application from the unit. I hope that the HSE would look favourably on that application.

I will share my remaining two minutes with Deputy O'Connor after the Minister of State has replied.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue and giving me the opportunity to provide an update to the House on the development of regional rehabilitation services in the South/South West Hospital Group. This is an important issue for all of those who live in the area. Rehabilitation is a critical component of any modern healthcare system and is essential if patients are to regain or maintain their quality of life after serious illness or injury. Rehabilitation improves health outcomes and reduces disability. There is a growing body of evidence that rehabilitation in specialised environments is not only effective but also cost effective. This has been demonstrated in a variety of settings such as inpatient units and community teams, and in different diagnostic groups such as trauma brain injury, stroke, multiple sclerosis and acquired brain injury.

The demand for rehabilitation services is growing and is anticipated to continue to grow with changes of population and the advances in healthcare, new interventions and technology. The model of care under the national clinical programme for rehabilitation medicine was launched in 2018 and presents, in line with National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011-2015, an outline for future provision of specialist rehabilitation services in Ireland.

The model of care proposed is a hub and spoke model consisting of a tertiary centre linking at least four managed clinical rehabilitation networks, each one serving a population of about 1 million people. The network will connect acute and post-acute rehabilitation units and community specialist rehabilitation clinicians in a formal governance structure to allow the delivery of co-ordinated rehabilitative care for patients across all levels of complexity.

The HSE has advised that a review of rehabilitation services in the South/South West Hospital Group was, as the Deputy said, undertaken in February 2017 and was further updated in May 2019. The review outlined a number of recommendations in regard to the development of rehabilitation services in the South/South West Hospital Group. The HSE also advised that, in line with the model of care for the provision of rehabilitation medicine in Ireland and the neuro-rehabilitation strategy, the review recommended the development of a regional specialist rehabilitation unit for the South/South West Hospital Group to support patients with moderate to severe physical, cognitive and communicative disabilities.

The HSE has further advised that the review recommended the development of a full range of rehabilitation services in the South/South West Hospital Group, including hyper acute rehabilitation as well as associated specialist post-acute inpatient rehabilitation units. The HSE has advised that these units will operate in a hub and spoke model with the National Rehabilitation Hospital in Dublin, through managed clinical rehabilitation networks, which is consistent with the model of care for rehabilitation medicine.

James O'Connor (Cork East, Fianna Fail)
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I wish to take this opportunity to congratulate the Minister of State, Deputy Butler, on her appointment. She and I go back a number of years and I know she is an exceptionally hard worker for the constituency of Waterford. I am deeply grateful that she has been appointed as a Minister of State.

As my colleague, Deputy O'Sullivan, has stated, a review of the patient services in the South/South West Hospital Group has been undertaken. I agree that such personnel should be located in Cork University Hospital, CUH, now that the process is under review. I welcome that a major trauma centre is to be placed in CUH to provide high to moderate intensive inpatient rehabilitation for patients who can tolerate an intensive rehabilitation programme or who require a structured environment.

It would be wise to locate one of these designated trauma units attached to such a major trauma centre in Mallow General Hospital. Mallow is the crossroads of Munster. It has great connections to CUH, and the development of the new M20 motorway will allow greater connectivity to the National Rehabilitation Hospital in Dublin. The location of Mallow General Hospital would fit excellently into the managed clinical rehabilitation networks hub and spoke model proposed under the review and should be taken into consideration.

Mary Butler (Waterford, Fianna Fail)
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Emergency trauma and medical care is now more responsive and effective and more people are surviving catastrophic injuries with complex life-changing neurological, vascular and orthopaedic effects. This has led to an overwhelming requirement for specialist rehabilitation services which are essential if patients are to regain or maintain a quality of life after serious illness or injury.

It is important to note that the Programme for Government: Our Shared Future has committed to the continued implementation of the neuro-rehabilitation strategy. The HSE has also advised that the South/South West Hospital Group and Cork Kerry Community Healthcare are progressing discussions in regard to the development of a rehabilitation unit in Cork which is consistent with the recommendations of the review of rehabilitation services in the South/South West Hospital Group. While discussions on this development have been delayed due to the Covid-19 emergency, it is expected that a submission will be finalised in the coming weeks.