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Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: I apologise; unfortunately, we do not have representation from the neurology clinical programme this morning. On behalf of the Neurological Alliance of Ireland, NAI, the national umbrella for more 30 neurological charities, I thank the Chair and members of the committee for their invitation today to consider the implementation of healthcare strategies for neurology and...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: The teams up and running at the moment precede the 2019 implementation plan. Those teams are in CHO 1 and CHO 3. It is important to say that they are not full teams. The team in CHO 1 in the north west has a whole-time equivalent of just three, whereas the recommended whole-time equivalent is 12. The team in CHO 3 in the mid-west has been up and running for over a...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Richelle Flanagan: I thank the committee for the opportunity to speak. I am a dietitian but I also live with young-onset Parkinson's disease. The neurorehabilitation teams are made up of health professionals such as an occupational therapist, a speech and language therapist, a physiotherapist, a neurorehabilitation consultant and a neuropsychologist, I think. Unfortunately, there is...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Seán Kyne: On neurological services in Mayo, or the unfortunate lack thereof, is there outreach from UHG to Mayo at present?

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: I am conscious that we unfortunately do not have the national clinical programme in neurology here to respond to that. I can only speak to what patients have told us. We do not speak for neurologists. We are aware the neurology services make every effort to ensure safe care and that people are seen when they need to be seen. We have spoken to patients and clinicians...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: As the Senator says, we do not have that expertise from the neurology programme with us this morning. We can certainly bring back any questions to those involved and follow up with the committee afterwards. I know from experience of working for many years in the NAI that there is a strong commitment among neurologists to ensure safe care. They will always prioritise...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Richelle Flanagan: I will follow up on access to care. I do a dietician call-back service for the Parkinson's association, so I talk to patients weekly. Lack of access to neurologists is a severe problem. We have the worst neurology to patient ratio in Europe at 1.3. The average in Europe is nine. We have 1.3. I spoke to a woman last week in Letterkenny, County Donegal, who was...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

David Cullinane: Looking at all of the figures in the opening statement, I reminded myself that there are real people behind them who need access to services. Whether that is the neurological teams in the community or the specialist beds, or the neurological nurses across the counties mentioned, there are people depending on these services. The first issue I raise is the specialist nurse positions. It...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

David Cullinane: There is a shortage of at least 100 specialist nursing posts. There was funding for 21, which is only a fifth of what is needed. Even at that, 13 of those posts have not been delivered and have been held up behind because of the embargo. That is the situation as of today.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: The responses we are receiving to parliamentary questions now indicate that it will be late 2024. We understand that this is an administrative issue; at least that is how it has been outlined to us. The commitment is there, but we have not seen the button pressed in order to have teams up and running.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

David Cullinane: It has identified the need for 300 beds, but only about one third of those are in place. That is a common pattern. It is the same with specialist nurses, where we have one third, or perhaps even less, of what is needed. It is the same for the teams. The whole area is under-resourced. I go back to what I said at the start of the meeting, namely that there are real people behind that who...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Róisín Shortall: It is quite unsatisfactory, if that arrangement had been made. The other thing, of course, is that we will have to have the HSE and the CEO back before the committee because very clear commitments were given to us this time last year. We took those commitments in good faith and they are not happening now. It is really disappointing. Apart from the rights of people with neurological...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Róisín Shortall: On the neurological teams, it is very disappointing. We were given a commitment that recruitment would take place in early 2024. Now, late 2024 is being said. Is that actually going to happen? Does Ms Rogers know what stage that recruitment is at?

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: This is just our understanding. We can clarify and urge the committee to seek clarity on this directly from the HSE. Our understanding is that recruitment has not commenced for those teams because the primary notifications have not been sent to enable those teams to move forward. That is frustrating in view of that commitment and special interest by the Minister of...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: We had a long dialogue on the neurorehabilitation strategy. Deputy Shortall has been extremely supportive. She has a long memory for some of the issues we highlighted. We came to the committee at a point four or five years ago when the neurorehabilitation strategy group was not meeting and there was a lack of energy and drive. We are happy to say that has...

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Róisín Shortall: There should be 108 multidisciplinary therapists in those teams. How many members of those teams are there at the moment? There are two teams in existence. It is hugely understaffed.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Róisín Shortall: To go back to Ms Rogers's point about the implementation strategy and the lack of energy, the implementation framework was established in February 2019. That is five years ago. How does that operate at the moment? Who is responsible for driving it?

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Ms Magdalen Rogers: The group now meets at least every eight weeks. As I said, there is very positive energy, commitment and drive to catch up on the strategy. It can only do that if it has funding and the administrative support and framework within the HSE to progress those teams.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Neasa Hourigan: Ms Rogers is absolutely correct. For clarity, there is an acceptance at those meetings that the recruitment embargo should not apply and yet it is repeatedly coming up in those meetings for discussion around the impact it might be having on the service.

Joint Oireachtas Committee on Health: Neurology and Neurorehabilitation Healthcare Strategies: Discussion (15 May 2024)

Neasa Hourigan: Let us stay on the issue of delay. As Ms Rogers has mentioned a few times, we were expecting to see some of those teams in place in early 2024 but now it will be late 2024, hopefully. Ms Rogers can tell there is a lot of frustration in the room. We had all thought we were moving forward and it seems now that we have delayed. It is worth contextualising that the teams that are already...