Seanad debates

Thursday, 16 December 2021

Nithe i dtosach suíonna - Commencement Matters

Hospital Staff

10:30 am

Photo of Eugene MurphyEugene Murphy (Fianna Fail)
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I appreciate the Cathaoirleach allowing this matter to be discussed. He is aware of its importance. I welcome my fellow county man, the Minister of State at the Department of Health, Deputy Feighan, to the House to reply on this matter. I know he has a good interest in it.

We have to consider the importance of this issue throughout the health sector. University Hospital Galway, UHG, is the western regional centre for neurology. However, it is short of neurology nurse specialists. Patients are waiting longer for diagnosis and treatment. National and international guidelines recommend that, on the basis of catchment area, there should be 13 neurology nurse specialists in this region but there are only four of them. Investing in more neurology nurses is a cost-efficient way of improving the efficiency of outpatient clinics, reducing waiting times and ensuring patients have access to the specialist support they need to manage their conditions. Patients who have access to neurology nurses have reported an improved sense of involvement in their care and being more prepared for tests and investigations. The provision of more neurology nurses will ensure that patients get quicker access to outpatient therapy, reducing waiting lists and ensuring any deterioration in the health status of patients can be mitigated. This will also ensure that additional hospital resources can be focused on those who need them.

I fully support the campaign of the Neurological Alliance of Ireland for 100 extra neurology nurse specialists, of whom nine will be for Galway. We should take note of all the areas of health that are related to neurology, such as epilepsy, head trauma, multiple sclerosis, motor neurone disease, headaches related to migraine, muscular dystrophy and other disorders, particularly those relating to the spine. There are 700,000 people in Ireland affected by neurological issues. The Minister of State may have some good news for me. I am very interested in appointments to UHG. I will speak about Cork University Hospital, CUH, in a moment. I particularly want to know about the clinical nurse neurology paediatric position, the paediatric neurodevelopmental position and the clinical nurse specialist dealing with neurology and headaches. The Minister of State may not have that specific information for me today. If he does not, I hope he will be able to provide it to me in the near future.

I refer to the west and north-west regions.There is a population of almost 600,000 people and University Hospital Galway is the centre of neurology to deal with that whole area. Some of the people campaigning for this have made the point to me that an additional nurse, who could talk to patients on the phone, can often talk a patient who is suffering from neurological issues through his or her circumstances and he or she may not need a hospital visit.

It is crucial we address this issue and that we seek better neurological services throughout the country for the many people who need them. I thank the Minister of State for attending. I hope he will have some good news for me.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for raising the issue and giving me the opportunity to update the House on the matter. Neurology nurse specialists play an important role in triaging, assessing and providing ongoing support to neurological patients, as the Senator outlined, which in turn builds capacity within neurological services and allows for more timely access to efficient, equitable and high-quality care for patients.

The national clinical programme for neurology, in conjunction with the Neurological Alliance of Ireland, completed an all-Ireland survey of neurological services in 2020. The survey highlighted that, although all neurological centres have access to a designated clinical nurse specialist or an advanced nurse practitioner, the total number of neurology nurses specialists is significantly below what is recommended in international guidelines. The national programme recognises the need to address this deficit to ensure the provision of efficient and timely care. An additional 16 clinical nurse specialists and advanced nurse practitioners have been sought for 2022 for different specialities in hospital groups. While a decision on funding is awaiting finalisation in respect of the HSE service plan, the additional posts sanctioned will initially address the areas of greatest geographical inequity and the sub-specialties most in need. Plans to increase incrementally the overall number of neurology nurse specialists will then be developed to address the remaining needs.

The national clinical programme for neurology recognises the value skilled and highly trained nursing staff add to the neurological services and has endeavoured to endorse this by focusing its current work streams and initiatives on nurse-led clinics, nurse liaison services and outreach programmes. Examples of this include the headache programme and the epilepsy outreach programme, both of which are funded under the Sláintecare innovation fund. These programmes involve the reconfiguration of the management of these conditions, enabling clinical nurse specialists and advanced nurse practitioners to lead and co-ordinate the care of these conditions in the community. This reduces the reliance on consultant neurologists and tertiary services, in turn reducing waiting lists, allowing more timely access to service and improving the overall quality of care, as the Senator outlined.

In regard to the catchment area of University Hospital Galway, Saolta University Health Care Group has advised that the current cohort of permanent neurology nurses in the hospital, which includes two advanced nurse practitioners, will be augmented by a further three appointments in 2022. The Senator asked about a few other appointments, and if he wishes, I will follow up with the Minister for Health or the Department.

Photo of Eugene MurphyEugene Murphy (Fianna Fail)
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I acknowledge the Minister of State realises we need more nurses in the neurology services. That is good news about University Hospital Galway. While it will not go the whole way, it will certainly make improvements, with three new appointments in 2022, I hope those appointments will happen in early 2022. I understand that, in the context of some of these matters, filling the position the nurse is leaving will be the issue. He or she may be ready to come into the neurological service but filling the position is an issue. Obviously, a person cannot be taken out of where they are working if there is not someone else to fill it.

I asked the Minister of State about a few specifics, which I probably should not have done because I did not give him advance notice. I appreciate his commitment to reverting to me on those matters.

Excellent work is done in Dublin and Cork in neurological services. Nevertheless, Cork University Hospital, for example, deals with a population of 1.5 million. The recommended outpatient waiting time should be six weeks but I am told the actual time is 18 months to two years. The recommended number of neurology nurse specialists in that area is 20. Overall, we need more neurology nurses.

I thank the Minister of State and appreciate him taking the matter.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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The national clinical programme for neurology recognises the importance of having an adequate number of neurology nurse specialists in position to provide efficient, high-quality care and ongoing support to neurological patients. The 2020 survey of neurological services highlighted that the total number of neurology nurse specialists needs to be increased to reach the levels recommended in international guidelines. It is planned additional posts will come on stream incrementally and the areas of the greatest need will be addressed first. The commitment of the national clinical programme for neurology to meeting the needs of patients is illustrated by proposed appointments such as those planned for University Hospital Galway, which the Senator welcomed.

The commitment of the Government to the provision of quality health services in University Hospital Galway is further underlined by the development projects under way there, including a new radiation oncology unit costing €56 million and the development of a temporary but substantial emergency department, ED, building in advance of the provision of a new emergency department and a women's and children's block.