The provision of medical rehabilitation services is a matter for the Eastern Regional Health Authority and the health boards in the first instance. A copy of the Deputy's correspondence has been referred to the chief executive officer of the South-Eastern Health Board with a request that he examine the matter and reply directly to the Deputy as a matter of urgency.
Effective rehabilitation draws on a broad range of services to meet the particular needs of patients, with the objective of helping patients return to normal life in the community. In the light of this, a large element of rehabilitation services is provided on a day or community care basis. The relevant services range from specialist in-patient medical rehabilitation through such services as physiotherapy, occupational therapy and speech and language therapy. These services are often initiated in the context of in-patient treatment for another underlying illness or condition and subsequently continued on a day care basis or in the community, consistent with patients needs. It is, therefore, more appropriate to focus on ensuring that rehabilitation is provided to patients in the most appropriate setting rather than on the basis of identifying dedicated services for particular categories of patients other than those requiring specialist in-patient medical rehabilitation.
The provision of appropriate rehabilitation care is also an integral element of the service required by many types of patients and proposals for development of additional capacity in the services that contribute to rehabilitation are often presented in the context of proposals for broader service developments. For example, the report of the review group on the waiting list initiative identified that a significant proportion of acute hospital beds were being inappropriately used by patients who did not need, or who no longer needed, acute hospital care. This problem arises due to a shortage of places in the areas of step-down or convalescent care, rehabilitation facilities and community based services which reduce the need to use acute hospital care.