The sorry state of neurology in Ireland: one year on

Last year I attended a meeting in Leinster House, the seat of the Irish government, organised by the Neurological Alliance of Ireland (NAI) to highlight the sad state of neurology in Ireland. What I heard and saw that day is still very much etched on my memory because of the impact it had (see blog post of 2013 here).

It was with great interest so that I attended the launch last week of the results of the 2014 national survey called ‘Living with a Neurological Condition in Ireland’ organised by the NAI in the Mansion House, Dublin.

The 2014 survey, which took place online between January 2014 and February 2014, examined the following aspects of living with a neurological illness:

Ψ Profiling Changes in Access to Services
Ψ Impact of Specific Cuts and Changes to Benefits and Entitlements
Ψ Profiling the Experiences of People with Neurological Conditions as a Group
Ψ Profiling the Experiences of Family Carers

In total, 601 people anonymously responded to the survey, the high number of respondents a success, reflecting the need ill people had to be heard. The need to be part of a solution toward better neurological services in Ireland, added value.

It’s quite clear that – even after the request of Ireland’s top neurologist to be angry at policies and health politics during the 2013 talk in Leinster House – neurology in Ireland continues to be a battleground in which patients are being hijacked by savage government cutbacks.

After stumbling my way through the 2014 NAI report (all 24 pages of it), I couldn’t possibly translate every eye-opening statistic as a person with neurological illness myself, and without getting angrier as page after page seemed to hit me harder and harder. While I need neurological services myself, I make do with what I still can do, or force myself to do. Once again, though, I truly feel for those in much worse situations than I am, because they are in a category of ill people not only time, but government after government seem to forget.

Of those who replied to the survey, 71% (425 people) are living with a neurological condition. The remaining 29% who replied, are family members of people living with a neurological condition.

The most common illnesses, where patients who replied for themselves, were:

Ψ Multiple Sclerosis (27%)
Ψ Epilepsy (21%)
Ψ Migraine (20%)

Where family members replied for those with neurological illnesses, the most common conditions were:

Ψ Epilepsy (25%)
Ψ Multiple Sclerosis (18%)
Ψ Muscular Dystrophy (17%)

The length of time people living with their neurological illness was 45% longer than 10 years, 23% between 5 and 10 years and 16% between 3 and 5 years.

Half of the respondents were in receipt of a medical card and 47% were in receipt of a social welfare payment as a result of their condition.

Employment figures are even bleaker than those figures above: “66% of respondents in total were working before the onset of their condition, 47% reported that they had to give up work while 18% had to cut hours as a result of their condition. These findings echo the results of recent research on multiple sclerosis, which indicates that 50-60% people have had to give up work following diagnosis.”

One of the most staggering results of the survey are those of getting access to services the past three years:

Ψ 28% said it has become more difficult getting a consultant neurologist appointment
Ψ 27% reported getting access to a neurosurgeon harder
Ψ 30% said it’s harder getting an MRI scan appointment
Ψ 34% reported getting a physiotherapy appointment more difficult
Ψ 45% said, getting respite care became harder the past 3 years
Ψ 47% said aid, appliance or specialist equipment being much harder to get

The percentages of people who haven’t been able to get services at all have all increased between 2011 and 2014 in these areas:

Ψ Consultant Neurologist Appointment
Ψ Specialist Nurse
Ψ Physiotherapy
Ψ Speech & Language Therapy
Ψ Occupational Therapy
Ψ Psychology
Ψ Respite Care
Ψ Aid, appliance or specialist equipment
Ψ Adaptation to my home

In the area of benefits and entitlements over the past 3 years,

Ψ Almost half of respondents, 46% reported a significant effect of increased cost of medications for their condition
Ψ 45% reported a significant impact of changes to the mobility allowance
Ψ 41% have been significantly affected by cuts to home care packages

Over one-third of respondents were dissatisfied with aspects of service provision to meet their needs, including:

Ψ Support in Planning for Future Needs: 40%
Ψ Psychological Support around the effects of the condition: 37%
Ψ Understanding of their condition by health professionals: 35%
Ψ Getting referred to services: 34%

Levels of reported dissatisfaction were higher for family members responding on behalf of a person with a neurological condition.

What scares me most of all though, is the projection the Central Statistics Office put forward, saying that:

Ψ In 2011, the CSO estimated that 762.960 people in Ireland would live with a neurological illness
Ψ By 2016, a whopping 824,743 will be affected
Ψ By 2021, an estimated 869,143 people will live with a neurological condition

This means that the projection also estimated that:

Ψ In 2011, a total of 44,880 would be diagnosed every year
Ψ By 2016, neurological illnesses would target 48,110 people
Ψ By 2021, a staggering 50,700 people would need to be able to avail of standard services that people with neurological people require. Not as a side dish to their everyday healthcare, but as a primary source of health care

A large part of Ireland’s population, so, already lives with an illness that affects their brain and spinal cord, the life-line of every human being. Yet despite statistics like this, Ireland’s national health department finds it OK not pouring extra funding in neurological services across Ireland.

Historically, demands for this kind of care kept increasing, while positive reinforcement of governments past, kept on living with their own kind of neurological illness, i.e. selective memory loss when these services so clearly demanded upgrades.

When you know that due to the nature of neurological conditions, patients need a large set of physicians and therapists, sometimes up to 40 healthcare professionals, then the question indeed is one of how you can balance governmental budgets versus the value of life and life expectancy of a neurologically ill person. Pharmacoeconomics have a strong a hold over patients, but the HSE doesn’t seem to care, and this needs to stop.

However, that doesn’t mean that politicians can or should not invest in this specific type of health care. In fact, they should invest year after year, not only to reflect an ageing population but also to show how well a government understands, supports and treats its electorate.

The meeting in Leinster House last year showed that a reconfiguration of existing could be done at no cost at all to the government, while they would get excellent services in place. This never happened.

In fact, one year later, nothing has changed. At all.

What if it was your mother, brother, father, sister, son or daughter, dear politician, who would need specialized care? Does these statistics not scare you? At all?

(excerpts on this blog post were taken from the NAI report, which can be found here).

For more info, please check these websites:


NAI Pre-Budget Submission 2014

National Disability Authority

Disability Federation of Ireland

Convention on the Rights of People with Disabilities

United Nations Enable

MS Ireland

Central Statistics Office

Houses of the Oireachtas

Budget 2014

The Sorry State of Neurology in Ireland

©Willeke Van Eeckhoutte and Ireland, Multiple Sclerosis & Me, 2011-2014. Unauthorised use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Willeke Van Eeckhoutte and Ireland, Multiple Sclerosis & Me with appropriate and specific direction to the original content.

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