Erin McGreehan (Louth, Fianna Fail)
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I am standing up here for the people of Louth because my constituents, neighbours and families are being denied essential neuro-rehabilitation services that most other regions have or plan to have. Let us be very blunt about it: Louth has no community neuro-rehabilitation team, CNRT, - not one. That is not because the need is not there; it is because one has not been provided.

The HSE has confirmed to me directly that HSE Dublin and North East which includes Louth, is one of the only regions in the entire country with no operational CNRT and no funded team. That has been written n responses to my parliamentary questions, in black and white, and it has real and devastating consequences for the people of my county.

Let us humanise this because it is not just about a line in the national service plan. Louth has stroke survivors trying to relearn how to walk and speak with no specialist community rehab team to support them. People with acquired brain injuries are being discharged from hospitals straight into a vacuum. Families are caring for loved ones with progressive neurological conditions without any structural follow-up. Patients are travelling across counties or simply giving up because the service or the medical team recommended to them does not exist. We are not talking about a luxury service; we are talking about physiotherapy, occupational therapy, speech and language therapy, psychology and medical rehab oversight. Those are the fundamentals of recovery and these are supports that determine whether persons regain independence or lose it permanently. Right now in Louth, that recovery depends entirely on a person's postcode, a system that is failing us. In reality, for every month Louth patients wait, they lose more function. For every year the team is delayed, more function becomes permanently lost. That cost is inaction, and that is what patients are dealing with.

Meanwhile, other areas, such as Galway, Mayo, Roscommon, Dublin south, Wicklow and Kildare, have received funding for 12 whole-time equivalents and teams are progressing with recruitment. We have been left behind in the north east. The HSE has confirmed year after year that it has submitted estimate bids to fund the CNRTs for the regions with nothing, including mine, and those bids have not been delivered. When I ask through parliamentary questions whether existing neurological services in Louth will be expanded or integrated, the answer is that we have to wait for the national service plan for 2026. When I ask about monitoring this, the reply is "details to follow"; when I ask about staff and recruitment plans, it is "not yet available". There is no timeline, no commitment or no clarity. It is completely unfair to the patients in County Louth and the people of County Louth that they are continuously waiting for this. We cannot leave families continuously waiting while the rest of the country moves on. There is no equity in that system. We cannot pretend that a region of nearly half a million people does not need what the HSE itself describes as essential population-based rehabilitation services.

I ask the Minister for an update on that and I hope there will be urgency on it.

John Cummins (Waterford, Fine Gael)
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I thank the Deputy for raising this important matter. It gives me an opportunity to respond on behalf of the Minister for Health.

The neuro-rehabilitation strategy implementation framework was launched in February 2019. The overarching aim of the strategy is the development of neuro-rehabilitation services to improve outcomes for people by providing safe, high-quality, person-centred neuro-rehabilitation at the lowest appropriate level of complexity. Services must be integrated across the care pathway and provided as close to home as possible.

Specialist neuro-rehabilitation services being established under the neuro-rehabilitation strategy will provide earlier access to specialist rehabilitation that improves people's outcomes, reducing their neuro-rehabilitation needs, enhancing function and reducing the supports required as they transition back into their communities.

As part of the strategy, the HSE is in the process of expanding the number of community neuro-rehabilitation teams across the country. The current position is that in 2025 four new teams have been recruited and will be operational this year. Some areas have partial teams in place but some areas, including Dublin and the north-east regional health area, have no teams in place currently.

Moving forward with the neuro-rehabilitation strategy, the aim is to enhance the existing CNRTs and fund those areas that do not have a community team to create a large population-based team within each regional health area.

A substantial amount of additional funding was provided for the continued implementation of the neuro-rehabilitation strategy in budget 2026. The details will be set out in the national service plan in 2026, which is due to be published shortly.

I take on board the points the Deputy has raised on behalf of her communities in the north east in relation to the absence of a team in her area. I will take back what she said to the Minister for Health.

Erin McGreehan (Louth, Fianna Fail)
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It is a pity the Minister is not here this morning because the Minister of State is reading out a response I have received several times to parliamentary questions. I know all this stuff. I also know that Louth does not have a community rehab team. I deal quite regularly with people who have acquired brain injuries, MS, FND or Parkinson's disease and they are not being cared for. The rationale is that they should go to Dublin, but the exhaustion of having to travel to Dublin from north Louth, south Louth or indeed mid-Louth is not acceptable. The stress of that is not good for health outcomes. The Minister of State said that we need to have the best outcomes or care pathways "as close to home as possible". The HSE is not even doing what it is recommending or what it is putting in replies for the Minister of State to say. This is for the Department of Health and the HSE. Again, it is the same answer about the HSE national service plan 2026. The reality is that County Louth has no neuro-rehabilitation teams. I need one, my constituents need one and the patients deserve proper care close to home, exactly what the HSE and the Department of Health clearly state.

John Cummins (Waterford, Fine Gael)
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The Deputy has articulated very well the importance of this service to her community in Louth and the entire north-east area of the country. There is a commitment in the programme for Government to ensure the continued roll-out of the neuro-rehabilitation strategy, and community teams form a critical element of that. Budget 2026 has invested significant additional moneys in this area. That will have to be reflected in the HSE national service plan. There is a commitment to focus on the areas that do not have a team and to expand the areas that have only partial teams in place.

Again, I will take the points the Deputy raised back to the Minister for Health.