As the Deputy has indicated, his question refers to a recent report compiled by the Neurological Alliance of Ireland. Neuro-rehabilitation health services are provided across a range of settings by different organisations and by many health professionals and carers. The Government has set out a four-year plan with a series of recommendations under the national policy and strategy for the provision of neuro-rehabilitation services in Ireland, which is running from 2011 to 2015. The HSE is committed to working with the national clinical programme for rehabilitation medicine to develop services based on the recommendations of this strategy. In this regard, the number of rehabilitation medicine consultants nationally increased from seven to 12 in 2013. Specialist inpatient and outpatient units have been identified to operate in each of the four current HSE regions, with clinical governance and expertise to be provided by the National Rehabilitation Hospital. An early access rehabilitation unit for Dublin and mid-Leinster, based at the National Rehabilitation Hospital, was set up in April 2013. This has delivered a significant increase in the throughput of patients treated.
I will use the remaining time available to me to address the question of medical cards, which was mentioned by the Deputy. I can refer to some of the other matters if necessary. The Deputy will be aware that under the provisions of the Health Acts, medical cards are provided to people who, in the opinion of the HSE, are unable without undue hardship to arrange GP services for themselves and their dependants. There is not and never has been an entitlement to a medical card based on having a particular disease or illness. The assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants, based on the HSE's income guidelines. The HSE routinely examines applications for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services. In such circumstances, it may exercise discretion to grant eligibility for a medical card on this basis. The Government recognises that neurological illness or injury has significant implications for the individual and his or her family. It has an impact on his or her social, educational, vocational and recreational participation. Waiting times, access, treatment and quality of care are priorities for reform for this Government. Despite the budgetary constraints we face, the Government is determined to create a new health service that can better respond to the needs of the Irish people.
