I thank the Minister, Deputy Gormley, for being here. He might not be the appropriate Minister, but I appreciate his presence.
I am raising the issue around the efforts being made to promote stroke prevention information and awareness, bearing in mind that a couple of years ago the stage was reachedwherein heart attacks might be prevented through the raising of awareness. I am told we are more or less at the same level of awareness today, as regards stroke prevention.
Around 10,000 people will have a stroke in Ireland this year. That is approximately one every 45 minutes. One in every five persons will have a stroke at some time in his or her life. Stroke is the third biggest killer in Ireland claiming over 2,000 lives every year. It has a higher death toll than breast, prostate and bowel cancer combined. Stroke is also the biggest cause of acquired disability and around 30,000 people are living with disabilities as a result of stroke.
Publication of the national cardiovascular health policy 2010-19 in May means historical progress in policy terms. It is recognised as a blueprint for the delivery of truly world class services in Ireland. However, there is no additional funding available for this preventative intervention. Implementing the report could eliminate avoidable death and disability from stroke in this country. Delivery of a comprehensive stroke service cannot be achieved without funding. The costs involved are small and much of the outlay will be recouped as a result of reduced numbers of stroke patients, shorter hospital stays and substantially lower nursing home costs due to lower levels of dependency.
The State is currently spending at least €500 million on stroke services every year. Eliminating avoidable death and disability does not have to cost more than this. Research commissioned by the Irish Heart Foundation, which is currently being conducted by the ESRI, is expected to show that following a relatively small initial investment, the development of world class stroke services in Ireland would be at least cost neutral and would possibly save the taxpayer money.
Stroke services are woefully inadequate in large parts of the country and in some places non-existent. For example, it is agreed that the death rate from stroke could be cut by 25% if all patients had access to stroke units. However, just 11 acute hospitals have any type of stroke unit. Thrombolysis is a clot busting drug that can have near-miraculous effects in preventing death and disability from stroke. The HSE says if services were better 20% of patients could benefit from such treatment. However, according to HSE figures, in the 12 month period to the end of April 2009, around 2% of acute stroke patients were thrombolysed. In large parts of the country it is either completely unavailable or only available to people who have a stroke from 9 a.m. to 5 p.m., Monday to Friday.
In the acute setting just one in four patients was recorded was having received rehabilitation according to IHF research. Stroke patients should be entitled to a minimum of 45 minutes of required rehabilitation five to seven days a week for as long as required. The reality is that no service is available to the vast majority of patients. Indeed even music therapy that can play a role in the issue of speech recovery, fails to gain professional recognition in this jurisdiction. We know what has to be done but funding needs to be available for vital improvements.
We spend around €500 million euro a year on what are perceived to be grossly inadequate stroke services. Improvements will carry some upfront costs in areas suchas stroke unit and thrombolysis provision, development of rehabilitation services etc. If there can be no new funding for stroke, there should be a reallocation of resources from the HSE's €15 billion annual budget to develop a proper service for the country's third biggest killer disease. By substantially reducing death and disability from stroke, substantial savings could make improvements cost neutral, freeing up hospital beds for patients with other less treatable diseases or conditions. In particular savings would accrue from reductions in the cost of institutional care, the length of hospital stay and the rate of readmission.
In a more general sense, given predictions of a 40% increase by 2020 in heart attack, stroke and other chronic conditions we urgently need to adapt our services and strategies to meet the changing face of cardiovascular disease, because although deaths may be falling, the prevalence of it is rising.
People of all ages need to be made aware of the risk factors for stroke and cardiovascular disease. They are very prevalent among the Irish population. Some 60% of adults over 45 years have high blood pressure, 80% have high cholesterol, 29% of all Irish adults are smokers, surprisingly a rise since the since smoking ban was introduced, and 61% of adults and about 20% of children and teens are overweight or obese.
Effective awareness campaigns are needed in stroke prevention as are stroke clinics. I am told that stroke is as preventable now as heart attacks a decade or more ago. Can we afford not to review our spend and do the frontloading to stop the major trauma that is left in the wake of stroke for patients and their families?
