Neurology: A leading neurologist has strongly criticised the Government's failure to implement the recommendations of a report into neurology services.
Dr Norman Delanty, a consultant neurologist specialising in epilepsy at Beaumont Hospital, Dublin, who described the shortage of neurologists in the State as "disgraceful", called on the new Health Service Executive to appoint a dedicated manager for each medical speciality.
"It is a very frustrating process looking for extra clinical posts. You draw up a proposal, fill in all the forms and go to the hospital management and the Department of Health. But all you meet is a 'blocking system', where your proposals just get swapped from department to department. The system resembles a Bermuda Triangle, he said.
"Unless doctors and patient support groups continue to lobby, nothing happens. It is a system that needs to change."
Dr Delanty was particularly critical of the difficulties in filling a post of consultant neurophysiologist at Beaumont. "At present, we have a band-aid service put together, while for three years we have been given the run around by the Eastern Regional Health Authority, the Department of Health and hospital administration."
Neurophysiologists are doctors who carry out and interpret vital tests such as electroencephalography (EEG), electromyography (EMG) and the intraoperative monitoring of patients undergoing brain surgery. The National Epilepsy Surgery Centre at Beaumont Hospital was experiencing "extensive difficulty" getting approval for a full-time consultant neurophysiologist, Dr Delanty said.
Among the recommendations made by a Comhairle na nOspidéal committee set up to review neurology and neurophysiology services in a report published in April 2003, was the need for six permanent consultant clinical neurophysiology posts in Dublin.
"The other major teaching hospitals in Dublin should each share a consultant post with the Neuroscience Centre at Beaumont Hospital," the Comhairle report said. It added that the centre in Cork University Hospital should have two consultant neurophysiologists with one consultant based in University College Hospital Galway. At present, there is just one permanent consultant neurophysiologist at Beaumont.
The Comhairle report called for an additional 15 consultant neurologist appointments to be made "as a priority" with a further 10 posts to be created within 10 years. "The committee believes that a ratio of one consultant neurologist per 100,000 population would be appropriate," the report stated. At present, there are 14 neurologists in posts in the State.
The report recommended that two neuroscience centres at Beaumont Hospital and Cork University Hospital as well as the existing neurological unit at University College Hospital Galway continue to be the focal points for the development of neurology and neurophysiology services in the Republic.
Ms Audrey Craven, chairwoman of the Neurological Alliance of Ireland (NAI), said she welcomed the report but wanted to see it implemented.
"The Neurological Alliance represents over 500,000 people affected by neurological conditions and we believe that the implementation of the report is long overdue. We believe that an increase in the number of neurologists, together with the development of a multi-disciplinary approach to the mix of neurological conditions, is vital."
The Minister for Health endorsed the Comhairle report in the Dáil last autumn.
Ms Craven said the NAI had requested a letter be sent by the Department of Health to all health boards confirming the Minister's approval, so that its recommendations would be implemented.