Colette Kelleher (Independent) | Oireachtas source

I welcome the Minister of State at the Department of Health, Deputy Finian McGrath. I also welcome the increased health spending announced in yesterday's budget, particularly provisions for home-care services and people with disabilities. With more money, the major challenge now is to ensure that the announcement translates into the much-needed services and supports for people who need them. This matter relates to the 25,000 people in Ireland who are living with neurological conditions and who need rehabilitation every year, and their carers.

Despite spending more money than ever before on health care, there are still dire shortages in some services. I want to draw the Minister of State's attention to the lack of core services for people living with conditions such as stroke, acquired brain injury, multiple sclerosis and Parkinson’s disease. Every year, over 25,000 people need rehabilitation and most of them struggle to get the services they require. Many need specialist services with skilled multidisciplinary teams to support them on their rehabilitation pathway. Without access to core rehabilitation services, people are left with preventable disabilities, cannot return to work and are accommodated in nursing homes, which can often be completely unsuitable for their needs.

This problem is at crisis level because services are under-developed and under-resourced. People with neurological conditions report the following problems with neuro-rehabilitation services. They include problems with availability and waiting lists, inequities in access, lack of clear pathways, lack of co-ordination and significant problems in navigating the system. It is bad enough to have been diagnosed with a stroke but the person must then try to find his or her way through a system in circumstances where he or she needs help. Other problems include lack of support and training for family members, lack of skilled neuro-rehabilitation health care professionals and failures in the Department of Health and the HSE to drive the necessary change relating to the growth and development of neuro-rehabilitation services.

Recent media coverage has highlighted these issues and how people are suffering as a result. We have heard from people waiting over two years for a place in the National Rehabilitation Hospital as well as people travelling abroad for rehabilitation and, what is worse, losing any gains when they return due to a lack of appropriate neuro-rehabilitation services in the community. Many more never got the opportunity to get the rehabilitation they needed and lost a vital window of recovery that will impact them for the rest of their lives.

The case I am about to outline is just one example.Mr. Colm Griffin was 36 years old, healthy and fit, and a qualified engineer. As a result of corrective surgery on an aneurysm in 2015, he had a stroke. The left side of his body was affected and he could no longer walk, use his left arm or dress himself. He was unable to drive or go to work. In Cork University Hospital, he got access to physiotherapy and hydrotherapy but otherwise the facilities were very limited. In February 2016, he got a bed in the National Rehabilitation Hospital and completed 12 weeks of therapy. Although the individual therapists did their very best, his experience was one of deep frustration as there are huge limitations on the number of therapy hours there. He kept a timetable from that time and recorded an average of three hours physiotherapy over five days and just one hour of hydrotherapy. In addition, there was no access to the facilities after hours or at the weekend. Since he returned home, friends and family had to fund-raise to pay for private physiotherapy.

Ireland should have 270 inpatient beds for our population but we have less than half of that and none outside Dublin. We should have four regional inpatient specialist rehabilitation services nationwide but we have none. There should be at a minimum nine community neuro-rehabilitation teams nationwide, one in each community health organisation as a starting point, but there are only three, and these are only partially staffed. We have the lowest number of consultants in rehabilitation medicine anywhere in Europe.

The lack of specialist and community rehabilitation services is impacting significantly on other areas of the health system, as the Minister of State knows, exacerbating the problem of delayed discharges from our acute hospitals. The national policy and strategy for the provision of neuro-rehabilitation services in Ireland was published in 2011 and it is unacceptable that there has been little progress in the development of new services since its publication. A long overdue draft implementation framework for the strategy was finally released, five years later, in February 2016. The Neurological Alliance of Ireland and others have serious concerns with the draft framework, which lacks dedicated funding and any timelines. It also lacks accountability and the scope required to deliver real improvements that people need. It is essential that a revised plan is put in place.

I wrote to the HSE, which has stated that it has long appreciated the need to review the issue. That is hardly good enough after five years. I would like specifics on what plans the Minister has in place to secure the 270 inpatient beds. When will these beds be in place? When will we have beds outside of Dublin in places like Cork? What about the four regional inpatient specialist services and when will the Minister put in place fully the nine community neuro-rehabilitation teams? We have waited a very long time and the people with the conditions are really in need and at risk. I would like some specifics and clear timetable.