Old-fashioned wards, insufficient beds and facilities which are cramped and out of date are placing a considerable strain on its work, says the National Rehabilitation Hospital.
The Dun Laoghaire-based hospital has sent an £18 million development plan to the Minister for Health with the aim of tackling these and other problems by 2005.
The NRH provides a rehabilitation service for about 1,000 patients a year who have suffered brain or spinal injuries, amputations and strokes. It has a special service for children. But it has 163 people on its waiting list and wants to reduce this number to 20. "We have high waiting lists, overcrowding in therapy areas, inadequate and ageing facilities and equipment, and inadequate staffing to deal with the more complex patient caseload which is presenting", says its chairman, Mr Henry Murdoch.
More people are surviving accidents and injury and patients are younger, according to the development plan. With the average age of patients falling, rehabilitation work goes on for longer, it says.
The hospital has 123 beds and "currently cannot cater for the needs of the entire population". It believes that if it had 160 beds it could meet the need "and still keep that homely environment which definitely augments the rehabilitation process among patients."
The hospital also has an urgent need for more staff, according to the plan, which says that "the team is under immense pressure to deal with the existing patient caseload, let alone develop as a state-of-the-art centre of excellence".
People with strokes were the main group of new patients admitted to the hospital in 1996, followed by amputees and people with brain or head injuries. In all, it had 424 new patients that year.
But readmissions account for the bulk of the hospital's work. Here, people with spinal, brain or head injuries formed the largest group of patients, followed by stroke patients.