Independent TD Carol Nolan has said that a detailed HSE reply to her parliamentary question on the implementation of the National Neurorehabilitation Strategy has revealed “a deeply troubling picture” of Ireland’s neuro‑rehabilitation services, with major shortfalls in capacity, unacceptable waiting times, and ongoing regional inequality that continues to disadvantage patients.
The Offaly deputy said the reply confirms that Ireland is operating with a national shortfall of more than 300 specialist neuro‑rehabilitation beds, despite clinical recommendations that each region should have a fully developed specialist inpatient service.
The Independent TD said the HSE’s own figures show that patients requiring specialist neuro‑rehabilitation face waiting times of 173 days for admission to the National Rehabilitation Hospital, with similarly lengthy delays at Peamount Healthcare and the Royal Hospital Donnybrook.
Deputy Nolan said the situation was “in a very literal sense, adding insult to injury to all of those patients recovering from stroke, brain injury, spinal trauma and degenerative neurological conditions.”
According to Nolan, the reply demonstrates that the National Neuro‑Rehabilitation Strategy, first published in 2011 and updated in 2019, remains very far from being fully implemented, with several regions still awaiting funding bids that will not be considered until Budget 2027.
She said the situation represents “a clear breach of even the most minimal expectations that patients depending on neurological rehabilitation rightly have.”
“This reply confirms what patients and families have been telling us for years, namely that Ireland’s neuro‑rehabilitation system is nowhere near fit for purpose. To have, 15 years on from the publication of the original Strategy, a shortfall of over 300 beds, and waiting times of almost six months, is simply scandalous.”
Deputy Nolan also commended the dedication of the neuro‑rehabilitation staff who continue to deliver care under extraordinarily difficult circumstances.
She said that therapists, nurses, consultants and community‑based teams are “carrying an impossible load” as they try to support patients despite chronic understaffing, long waiting lists and the absence of adequate specialist bed capacity.
Deputy Nolan concluded by describing their commitment to patients as “beyond admirable” and that the failures highlighted in the HSE reply “reflect systemic shortcomings, not the efforts of frontline professionals who are doing everything they can with the limited resources available.”
Minister for Health, Jennifer Carroll MacNeill said that The Programme for Government – ‘Securing Ireland’s Future’ – includes a commitment for advancing neuro-rehabilitation services in the community. The Health Service Executive is leading on the implementation framework in respect of the recommendations of the National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011-2015.
“The Neuro-Rehabilitation Strategy Implementation Framework (IF) was launched in February 2019. The overarching aim of the Strategy is the development of neuro-rehabilitation services to improve patient outcomes by providing safe, high quality, person-centred Neuro-Rehabilitation at the lowest appropriate level of complexity. This must be integrated across the care pathway and provided as close to home as possible or in specialist centres where necessary. These services are to be configured into population based Managed Clinical Rehabilitation Networks (MCRNs). The overarching aim is the development of population based MCRN’s around the country.”
“The HSE has undergone a significant restructure to establish six new Regional Health Areas (RHAs) replacing the Community Health Organisations (CHOs). The implementation of the National Neuro-Rehabilitation Strategy is in alignment with the introduction of the six RHAs with the vision being to develop a population based MCRN in each RHA. Each MCRN has access to the National Rehabilitation Hospital, a Regional Specialist Inpatient service and a Community Neuro-Rehabilitation Team (CNRT),” she said.