Tuesday, 21 June 2016
I thank the Minister, Deputy Harris, for addressing us. I welcome the Minister of State, Deputy Corcoran Kennedy, to the House for the debate.
Like my colleagues, I support the setting up of a cross-party health committee which will have a longer-term focus with regard to health policy over the next ten years. That is welcome. During the recession health budgets were hit but now that we are in a better economic position it is important that we direct our resources appropriately towards the fairer delivery of services for our people.
I would like to refer to many issues within the health service but I will focus on the area of stroke care. The suddenness of a stroke can be very difficult for patients, families and carers. The effects of a stroke range from very mild difficulties such as hand weakness to more complex challenges such as speech difficulties, sight loss or paralysis on one side of the body. As an occupational therapist who has specifically worked with stroke patients for the past eight years I have become deeply frustrated when, following a stroke, many of our patients are unable to gain access to specialist rehabilitation in a timely manner. There is such potential for these individuals to improve given the right access to services.
An audit report on stroke services carried out by the Health Service Executive, HSE, and the Irish Heart Foundation published in January this year found that the death rate from stroke has dropped from 19% to 14% since the last audit was carried out in 2008. Some 8% of stroke patients are being discharged to nursing homes compared with 15% in 2008. That marks a substantial reduction, which is most welcome.
The Minister, Deputy Harris, rightly said there are good developments every day within our health service and those changes are very much driven by the HSE national stroke programme currently led by Professor Joe Harbison, who has shown great leadership in terms of the reorganisation of acute stroke services. We have improved the position from one stroke unit to 21. We have ensured that we have approximately 250 medical doctors trained in thrombolysis or clot-busting treatment. That means real improvements are being made in the initial stages following a stroke.
However, stroke remains Ireland's biggest killer after cancer and heart disease. Our stroke patients must be treated with the same level of urgency as that of cancer and heart disease. The key finding of the audit was that a very high proportion of survivors suffer needless disability, and I listened attentively to Senator Dolan's contribution, because of a lack of rehabilitation services once they have been treated in hospital for a stroke. With medical advances we must have better and more timely access to rehabilitation services. It is important to consider rehabilitation services within the context of community services and hospital services for those over and under 65 years of age.
The audit also shows that only about half of patients are admitted to a stroke unit at any one time during their hospital stay. In 2016, treatment in a stroke unit is the most basic requirement. All of the clinical evidence supports the benefit to stroke patients and improves their outcomes and their recovery.
For patients under the age of 65, the position is of even more concern. Those patients find it extremely difficult to get access to inpatient rehabilitation services because the only one we have is the national rehabilitation service in Dún Laoghaire. Many of our patients are waiting months. We need to make sure that our multidisciplinary teams are properly resourced.
One of our major challenges in terms of rehabilitation is the delivery of more units. I ask the Minister of State to ensure that the specialist rehabilitation unit planned for Roscommon hospital is progressed as quickly as possible. It is essential that the project team comprising hospital, clinical and estates personnel is assembled as quickly as possible, and I ask the Minister of State to ensure that happens without delay. We must ensure that we are providing proper services for the people of the west, who find themselves in a very difficult position where they require rehabilitation.
In terms of the early supported discharge services, I ask that there would be a greater focus on community care and properly resourcing our early supported discharge teams.