Dáil Éireann Debate, Wednesday - 5 December 2018
35. Deputy Margaret Murphy O'Mahony asked the Minister for Health when an implementation plan for the national neurorehabilitation strategy will be published; and if he will make a statement on the matter. [51153/18]
View answerWhen will an implementation plan for the national neuro-rehabilitation strategy be published and will the Minister make a statement on the matter?
The national policy and strategy for the provision of neuro-rehabilitation services in Ireland, 2011-2015, was published in 2011. Its focus is on achieving best outcomes for people by providing safe, high quality, person-centred care at the lowest appropriate level of complexity. This must be integrated across the care pathway and provided as close to home as possible or in specialist centres, where necessary. A national steering group, with representation for all relevant stakeholders, was established to oversee the writing and execution of an implementation framework for the strategy.
The HSE recently finalised its implementation framework in respect of the recommendations of the national neuro-rehabilitation policy and strategy. I welcome the completion of the framework, which I received on 20 September. I greatly appreciate the work of the HSE and the national steering group in finalising the framework and I look forward to its roll-out in the coming years.
The framework will guide the reconfiguration and development of neuro-rehabilitation structures and services at national and local level. It proposes the formation of managed clinical rehabilitation networks, with the set-up of one demonstration network suggested as the first step. The delivery of the national neuro-rehabilitation policy and strategy remains a priority for me and is a commitment under A Programme for a Partnership Government. As I stated, the implementation framework is now completed and has been signed off by HSE management. Publication of the framework, and this is the key point, is a matter for the HSE. I am advised, as late as yesterday, by the HSE that the framework will be published in the coming weeks.
I ask the Minister of State to make sure that this does happen. The national policy and strategy for the neuro-rehabilitation services 2011-2015 was published by the Department of Health and the HSE almost seven years ago to the day, on 16 December 2011 with an implementation plan promised within six months. Seven years on, however, this four year plan has no implementation strategy. The Minister of State announced in February 2017 that the plan would be published before the end of that year. A Dáil motion debated and approved this time last year called for it to be published this year. We are nearly at the end of 2018 now and nothing is happening. No date is available for the publication of the plan even though I understand the Minister of State received a completed plan from the HSE in July. Can he confirm this please?
I share the Deputy's concerns but it will happen. According to my information, as of yesterday, this plan will be published in the coming weeks. In my diary that is before Christmas.
Of course we have to be very careful about ensuring we have a plan and strategy particularly for people in these situations. The main premise underpinning all rehabilitation service delivery is the model of care.
We need a person-centred approach to patient care, the development of appropriately resourced interdisciplinary teams, outpatient and community based specialist rehabilitation teams across the country, case management of patients, and management of clinical rehabilitation networks. That is the model of care, but we must also include the implementation aspect. That is centred around the development of local implementation teams, the development and enhancement of neuro-rehabilitation services at each level of the network, the configuration of services into a managed clinical rehabilitation network and governance structures, including all leadership and accountability aspects. This is an issue we have to push and I expect to have further details in a matter of weeks.
I will hold the Minister of State to that. He will forgive me for being slightly suspicious that this may not happen. We have been given several dates already and I will hold him to this one. There are only a few more sitting days before the House adjourns for Christmas. Time is flying and I ask the Minister to do his best to work on this matter.
The national policy and strategy for the provision of neuro-rehabilitation services was published in December 2011. Since then, there has been no new investment in community neuro-rehabilitation services. At least one team should operate in each of the nine community health organisations. However, we still have only three teams, the same number as in 2011, and they are only partially staffed. The HSE has established a critical pilot project for the development of neuro-rehabilitation services in CHO 6 and 7 and appointed a project manager. However, that project cannot proceed effectively without dedicated funding in 2019.
I confirm that I received the framework on 20 September. I accept the Deputy's point. I am informed that the HSE will publish it within weeks.
I work very closely with the neuro-rehabilitation services. I visit many of the centres and meet many of the people involved in them. One of the first groups I thought of last Friday when the Minister for Health, Deputy Harris, and I announced changes to the medical card system to give effect to the key recommendation of the Make Work Pay report for persons with a disability was the young men and women I have met in the past three years, particularly those with physical disabilities. I was delighted to be part of the announcement that the earnings disregard for persons in receipt of disability allowance will be substantially increased from €120 to €427 a week. That is an increase of more than 250% in the earnings disregard for people with a disability.
We have to drive this issue. It is very important that we support the rehabilitation strategy and plans. That is a priority for me and I will drive forward this project in the next couple of weeks.
