Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I am glad to share time with my good colleague, Senator Buttimer. I will outline the facts from letters I received. Cork University Hospital, CUH, is the south-west region's centre for neurology but is short of neurology nurse specialists. Patients are unnecessarily waiting longer for diagnosis and treatment. Based on the catchment area, national and international guidelines recommend that there should be 20 neurology nurse specialists, but there are only four in Cork. This is a disgrace.

I have already confessed that I suffer from a neurological ailment. God forbid if somebody in west Cork or south Kerry, a long way from the CUH, had a seizure or difficulty and got to CUH to find he or she is waiting on a trolley because of the lack of neurological specialist nurses. It is a disgrace. In Dublin, you have several hospitals you can fall back on, like St. James's, Beaumont, Mater private and others, but the south west is being neglected. It is a life-threatening situation when there is a neurological emergency.

I urge the Minister of State to reflect on this. If there were 16 neurological nurse specialists in the CUH for this region, I probably would not complain. However, four is one fifth or 20% of what national and international guidelines suggest. I will hand over to Senator Buttimer, who is far closer to CUH than I am and who is probably more knowledgeable than me about this issue.

Jerry Buttimer (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Senator O'Donovan for allowing me to share time with him. He is living the experience and has made two pertinent points about care and access to care. This is about quality of life for people and about access to service. There is a critical gap in the care of those with a neurological condition.

The theme of the campaign is "Patients Deserve Better", which highlights the need for 100 specialist neurologists in nursing and is also about the four we have in Cork and the 16 needed to provide, as Senator O'Donovan said, essential care to people with neurological conditions. One example involves a gentleman I know, Declan Groeger, who suffers from multiple sclerosis, MS, and who says:

There is one neurological nurse in CUH for epilepsy, one for stroke and there are two nurses for every other neurological patient. The two nurses I deal with are excellent but they are not MS specialists.

We need to ensure critical care is given for MS, Parkinson's disease, epilepsy and other rare neurological conditions. We are highlighting the gap in the provision of services. We accept that much work is being done, we commend all of those doing the work and we understand that there is an issue with recruitment. However, just four nurses in Cork University hospital is a shortfall that we hope will be addressed as part of the HSE development plan for the Cork-Kerry region.

We had a briefing on community care last Monday with the HSE. This matter does not fall under community care but under hospital services. I support the neurological association of Ireland. Deputy Colm Burke is having a briefing today in the audiovisual room on this matter and the issue of provision of neurological care. It is about making sure we put in place extra nurses.

Frank Feighan (Sligo-Leitrim, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Senators for the opportunity to address the House on this important matter on behalf of the Minister for Health, Deputy Stephen Donnelly. I acknowledge the work and role played by neurological nurse specialists in the care of patients. They play an important role in triaging, assessing, and providing ongoing support to neurological patients. This in turn builds capacity within neurological services and allows for more timely access to efficient, equitable and quality care.

I am advised that the HSE's national clinical programme for neurology, in conjunction with the Neurological Alliance of Ireland, NAI, completed an all-Ireland survey of neurological services in 2020. This survey confirmed that all neurological centres have access to a designated clinical nurse specialist and-or advanced nurse practitioner, recognising the value that skilled and highly trained nursing staff add to neurological services. The HSE has advised that plans will be developed to incrementally increase the overall number of nurse specialists.

The national clinical programme for neurology continues to engage regularly with patient organisations and the NAI to establish ways to promote neurology nurse specialists. It is focusing its current work streams and initiatives around nurse-led clinics, nurse liaison services and outreach programs. Examples of this include the headache and epilepsy outreach programmes, both of which are funded under the Sláintecare innovation fund. These programmes reconfigure 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 reliance on consultant neurologists and tertiary services, in turn allowing more timely access to services and improving the overall quality of care.

The HSE has advised that all funded neurology nurse specialist posts in CUH are filled. There are currently five specialist nurses working within neurology services at the hospital. In addition, a candidate advanced nurse practitioner for epilepsy is going through the HSE recruitment process.

In 2021, the South/South West Hospital Group sought and received approval for two additional consultant neurologist posts to improve services at CUH. The consultant applications advisory committee recently approved these posts and recruitment is progressing to fill them. A second consultant neurophysiologist was recently appointed in CUH. An initiative to convene after-hours outpatient department clinics to address the issue of those obliged to wait a long time is also under discussion.

The Government is committed to improving patient services and having patient-centred care in Cork and across the country. That commitment is reflected in the unprecedented level of funding that is being targeted across the health service in recent budgets and again in budget 2022. I am assured that the South/South West Hospital Group remains committed to the development of neurology services within the group, and to improving these services for patients of the south and south-west region.

Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for coming in. He is basically the messenger. It reminds me of somebody in a football game who is 20 points to four down at half-time. I do not think we will win this match, but I stress that the situation is serious. In my view, what is happening is not tolerable. I hope the Minister of State will convey to the senior Minister that Senator Buttimer, I and others cannot stand for this. It is deplorable.

Jerry Buttimer (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I concur with the remarks of Senator O'Donovan. I thank the Minister of State for his reply. It is inadequate in terms of the development of a tier 1 hospital that is the primary hospital for the southern region. The issue of neurology is gaining a cohort of people every day.

We need a joined-up approach. This is about continuum of care and allowing people to go out from hospital knowing that if they need someone, there will be someone there for them on their return. Senator O'Donovan and I will keep up the battle in respect of this matter.

Frank Feighan (Sligo-Leitrim, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I will bring the Senators' concerns back to the Minister for Health. The Government is committed to improving services in line with Sláintecare. The development of these services provides an opportunity to make significant changes to the quality of life of our citizens. The South/South West Hospital Group remains committed to the development of neurology services within the group. There are currently five specialist nurses working in neurology services at CUH, and two additional consultants are being recruited. The national clinical programme for neurology is focused on ways in which improvements can be made that will benefit patients. This includes the promotion of neurology nurse specialists through nurse-led clinics, nurse liaison services and outreach programmes.In addition, the headache programme and epilepsy outreach programme, both funded under the Sláintecare innovation fund, aim to reconfigure the management of these conditions by enabling clinical nurse specialists and advanced nurse practitioners to lead and co-ordinate the care of these conditions in the community. This reduces reliance on consultant neurologists and tertiary services, in turn allowing more timely access to services and improving the overall quality of care. The work of the HSE, and of the national clinical programme in particular, will improve services for patients in the south and south-west region through more timely access to services and improving the overall quality of care.