‘Significant geographical inequity’ in neurological care, health committee told

There is a “significant geographical inequity” in delivering care to those with a neurological condition in the State, the Health Service Executive’s (HSE) clinical lead for the speciality has said.

Speaking at a meeting of the Oireachtas health committee on Wednesday, Prof Orla Hardiman said the disparity in the provision of services across the country has had an impact on waiting lists and waiting times.

“Unfortunately, we have a very significant geographical inequity with respect to the delivery of care for people with neurological disability. It’s very much the case in the northwest of the country and to some extent the southeast part of the country,” she told politicians.

“The regional inequity is very significant and that has very much impacted the waiting lists for people with neurological disabilities.”

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Prof Hardiman highlighted gaps in service provision in Galway and Sligo, adding there is a "very significant unmet need" in Letterkenny and the Donegal region.

“That whole western part of the country is very poorly served at the moment,” she added.

Magdalen Rogers, executive director of the Neurological Alliance of Ireland, an umbrella group of organisations, said in February there were 23,815 people waiting for a neurology appointment, compared with 13,218 in 2015.

In January, 7,587 patients were waiting more than 18 months for an appointment, an increase on the 4,871 waiting for this length of time in January 2019.

“Covid-19 has had a serious impact on access to treatment and care for people with a neurological condition due to the closure and containment of services and redeployment of staff,” she said.

"However, in Ireland this impact was exacerbated by the fact that both neurology and neurorehabilitation services were already significantly overstretched and under-resourced pre-pandemic."

Ms Rogers said there is a "critical shortage" of nurse specialists in this area, with a shortfall of 100.

“This means that four-fifths of Irish people living with Parkinson’s disease, for example, do not have access to a nurse specialist. There are no specialist nurses for rare, complex conditions such as Huntington’s disease,” she said

Staffing levels have “not kept up with the pace of demand” and caseloads for nurse specialists who are in place “are far in excess of what they should be”, she added.

The Neurological Alliance has called on the Government to recruit “significant additional numbers of nurse specialists in neurology services, as well as other clinical staff, as part of a five-year plan to implement the model of care”.