With just 22 consultant neurologist posts filled, we are well short of the 42 we need, writes Dr Muiris Houston
LAST YEAR, a GP in rural Ireland was consulted by a woman from eastern Europe with symptoms of a slipped disc in her spine. She needed an MRI scan, but the best the local hospital could do was to offer her an appointment some nine months later.
Faced with a prolonged period off work, the woman told her GP that she would sort out the impasse.
The following Monday she arrived back at his surgery carrying an MRI scan and an envelope.
She had had the scan and had seen a consultant neurologist in her home country on the previous Saturday.
Her family had obtained the appointment for her at three days notice and she had flown home for the weekend on a budget airline.
Her Irish GP then treated her appropriately based on the results of the MRI scan and the specialist opinion from eastern Europe.
Although it may sound apocryphal, this story is true. It illustrates the paucity of neurological services in the State, a situation that has improved little despite a recent injection of funds by the Health Service Executive.
With just 22 consultant neurologist posts currently filled, we are well short of the 42 we need. And we are simply not at the races when it comes to the number of so-called allied health professionals – occupational therapists, psychologists and others – who are the cornerstone of treatment and support for the typical person with a chronic neurological condition.
A strategic review of neurology services says we are so short of these professionals that even those lucky enough to have got into hospital can wait up to two weeks to see a therapist. And if you are an out-patient with a disabling condition such as multiple sclerosis, you are likely to wait three to six months to be treated.
As for services in the community, patients with neurological conditions either go without, or go private. This situation continues even as we export up to 300 therapists annually to work abroad, despite setting up third-level courses some years ago specifically to meet the anticipated demand for these skilled professionals.
At a time of deep economic recession, and with no concrete plans yet in place to offer redundancy to health service bureaucrats, people are rightly angry. How can we justify layers of administration when patients’ health is compromised? Especially when we see how inefficient that bloated administration is in the way it dealt with the neuroscience report.
First the monolithic HSE set up and resourced a national working group on neurological conditions. But when the group, which includes senior members of the HSE’s own management submits a report, it fails to acknowledge receipt. Then, after a number of reminders a meeting is arranged some nine months later.
The outcome? The HSE decides to send the report for “external review”. This means asking two specialists from abroad, with no experience of the Irish health system, to assess how appropriate your own expert report is.
If both our health service and our economy were not in such a mess, it might even be funny in a Yes Minister sort of way. But it is far from amusing for the three-quarters of a million people in the State who have epilepsy, multiple sclerosis, dementia and other neurological conditions.
The reality for them is that when they first develop symptoms they cannot access a consultant opinion in a reasonable timeframe.
Neurology: by the numbers
Three-quarters of a million people in the Republic have a neurological condition
45,000 people will be newly diagnosed with a neurological problem in 2011
66,000 carers will be looking after a person with a neurological condition in 2011
Up to 7,500 people in the Republic have multiple sclerosis
Almost 45,000 people will have dementia in the Republic by 2011