Dáil Éireann debate -
Wednesday, 30 May 2001

Vol. 537 No. 3

Written Answers. - Hospital Services.

Richard Bruton

Question:

146 Mr. R. Bruton asked the Minister for Health and Children if he has satisfied himself with the aftercare services available for persons who suffer brain injury; if his attention has been drawn to the fact that some people who suffer brain injury receive no rehabilitation after discharge from acute hospitals; and if he will enter into discussions with carer groups such as Headway so that a more structured programme can be developed. [16142/01]

Minister for Health and Children (Mr. Martin)

As the Deputy is probably aware, acquired brain injury in young adults is most often sustained as a result of road traffic accident, sporting accident or fall. The degree of sustained disability is ultimately dictated by the location and severity of the injury to the brain and can range from being mild and, with the assistance of appropriate services, short-term to severe requiring ongoing support services or constant nursing care.

Individuals with an acquired injury form part of a larger client group, known as the "Young Chronic Sick". The need to provide step down rehabilitation services to deliver ongoing therapeutic programmes to the young chronic sick on discharge from acute hospital care or medical rehabilitation has been identified as a priority service for development. In the case of acquired brain injury, this service will provide the appropriate therapeutic programmes to enable those with cognitive impairment and psycho-social functioning problems, including the milder syndromes of inappropriate behaviours, to make the transition from hospital to the community. Needless to say, because these conditions are generally acquired in adolescence or early adult years, significant psychological strain is placed on the family and the ongoing care and support required by the individual and his or her family needs to be addressed within the community support services.

For those individuals, for whom the severity of their condition is such that they are unable to return to or remain at home, there is a need for the provision of appropriate residential care, which has been identified as a requirement for specialised units, providing constant nursing care, for individuals with severe acquired brain injury. Such specialised units would also provide respite care.

I have provided just over £92 million under the national development plan for services for people with physical and sensory disabilities, including the development of step down rehabilitation and long-term care service for people with acquired brain injury.

In June 2000, I met Irish Neurological Alliance to discuss its report, Standards of Care for People with Disabling (Progressive and Static) Neurological Conditions in the Hospital and Community. The Irish Neurological Alliance is representative of a number of support groups, including Headway. Last year the Irish Consultant Neurologists Association made a submission to my Department which sought to increase the number of consultant neurologists in this country to meet an increasing demand from people presenting with neurological disorders. The report considered the need for further expansion nationwide, as the nature of neurological practice is changing with new effective complex therapies for many disorders becoming available. The challenge is to develop an integrated and co-ordinated health and social welfare system that is geared towards the needs of the individual.

Comhairle Na nOspidéal is the statutory body whose main function is to regulate appointments of consultant medical staff in hospitals providing services under the Health Acts and to specify qualifications for such appointment. It also advises on matters relating to the organisation and operation of hospital services and publishes reports relating to services. Arising from a number of meetings with various interest groups, I have requested Comhairle Na nOspidéal to conduct a review of neurological services and related issues. The need for additional investment in neurological and neurosurgical services will be considered in the light of this review, other competing priorities and the availability of funding.

I look forward to receiving an chomhairle's report in due course. The need for additional rehabilitation beds has been identified in the review of bed capacity. This review is at an advanced stage and the findings will be brought to Government in the near future. I accept that there is a need to provide facilities which can meet the needs of patients requiring access to rehabilitation services. These include selected groups with specific conditions, such as acquired brain injury, who require continuing care in a setting appropriate to their needs.