Neuro-rehabilitation health services are provided across a range of settings, by different organisations and by many health professionals and carers. The Government has a plan, with a series of recommendations, under the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland. The Health Service Executive has established a steering group to develop an implementation plan for the Strategy, working with the National Clinical Programme on Rehabilitation Medicine.
The National Rehabilitation Hospital is currently resourced for 3 beds for patients with highly complex care needs, for example, patients who are minimally conscious or have a disorder of consciousness. The level of resources needed to provide for the complex care and treatment needs of this patient group is significantly higher than for patients who have a certain level of mobility or independence. The National Rehabilitation Hospital actively manages the waiting time for admission to the high intensity rehabilitation beds.
The Government has committed to part funding a new 120 Bed Rehabilitation Hospital with Integrated Therapy spaces to replace the existing National Rehabilitation Hospital, at an estimated cost of €54 million.
In the past couple of years, four new Consultants in Rehabilitation Medicine were appointed to the National Rehabilitation Hospital, in addition to the existing seven Consultants at the hospital.
The White Paper on Universal Health Insurance (UHI), published by Government on 2nd April 2014, indicates that under UHI, citizens will have access to a package of primary and acute hospital services, including acute mental health services. Decisions on the composition of the future health basket will be informed by the Expert Commission which the Government will establish shortly. The Commission is tasked with providing a series of costed options to the Government on a wide range of services to be included in the UHI standard package services. It will provide details on the nature and type of the service, including any conditions and targeting that should apply in relation to the coverage of services. It will also advise on the services to be provided within the overall health basket. The inclusion of neuro-rehabilitation care services in the standard package of UHI will be considered as part of the process. It is the Government's intention that UHI will be introduced by 2019.
The Government recognises that neurological illness or injury has significant implications for the individual and their family, which impacts on their social, educational, vocational and recreational participation. Waiting times, access, treatment and quality of care are priorities for reform for this Government, despite budgetary constraints.