The planned €50 million National Centre for Epilepsy would provide assessment and treatment for public and private patients, writes Genevieve Carbery
A PRIVATELY FUNDED not-for-profit centre for epilepsy is being proposed for the north side of Dublin which should be open in three years, according to the project's proposers, who include a number of leading neurologists and researchers in the area.
The proposed €50 million National Centre for Epilepsy will provide assessment, treatment and therapy for public and private patients with epilepsy.
Consultant neurologist and director of the Epilepsy Programme at Beaumont Hospital, Dr Norman Delanty and epilepsy patient Brian Geraghty came up with the idea of opening the centre and are two directors of Epilepsy Clinic Ltd, the company behind the project.
Others involved in the project include Dr Colin Doherty, consultant neurologist at St James's Hospital, Mary Fitzsimons, principal physicist at Beaumont and promoters include Brainwave: the Irish Epilepsy Association.
"Frustration" is the reason Dr Delanty gave for getting involved in the centre as he has spent a lot of time apologising for the current system. He has recently had to curtail referrals from family doctors and has so many patients it is difficult to cope, he said. "We are trying to turn frustration into concrete action," he added.
Brian Geraghty got involved in the project because as an epilepsy patient it took a long time for him to be diagnosed when he developed the condition following an accident at 19 years of age. It took about 10 years for him to be stabilised but when he finally got a neurological bed, stabilisation only took nine days, he said.
Of the 40,000 people with epilepsy in Ireland, some 16,000 suffer from "drug-resistant" epilepsy that is difficult to control. These require a detailed inpatient assessment in order to decide whether treatment with brain surgery would benefit them.
There is a two-year waiting list for assessment at Beaumont's national neurology centre, with nine-month waits for a neuropsychological evaluation and six-month waits for other tests which are essential before surgery, Mr Delanty explained. Waiting lists for private neurology patients are as long as the public waiting lists, he added.
The proposed centre will provide "a one-stop shop" assessment for people before surgery as well as for those suspected of having epilepsy, that would be waiting a long time otherwise, Dr Delanty said. It will offer full assessment within the same day including MRI scan, EEG tests and blood tests and as a result treatment decisions can be made more quickly, Mr Geraghty explained.
The proposed centre will also provide 24-hour monitoring with video telemetry to establish the extent of a patient's seizures and assess the type of epilepsy they may have. In addition it will also provide post-surgery respite, outpatient facilities and multidisciplinary care.
However, neurosurgery will not be available at the proposed centre and surgical patients will be referred to Beaumont Hospital. Dr Delanty hopes the centre will ease pressure on Beaumont's neurological facility and said the response from colleagues at Beaumont had been positive. By having proper assessment and giving the surgeons an idea of what needs to be done, the centre will help to shorten waiting times for surgery, Mr Geraghty argued.
Dr Delanty said he would retain a link at Beaumont and hopes the centre can come to an arrangement with the HSE so that the centre's five consultant neurologists could offer 20 per cent of their time to Beaumont.
There are three Irish consultants working abroad with a specialisation in epilepsy who are prepared to come to work at the centre, Mr Geraghty said. There are enough trained neurologists available for Ireland as every post advertised has 10 or more applicants, Dr Delanty said.
A freeze in HSE recruitment hindered epilepsy research in Beaumont last year. However, the proposed centre will have its own research department backed by the Royal College of Surgeons in Ireland (RCSI)which will put a focal point on otherwise scattered epilepsy research, Mr Geraghty said.
The proposed centre was welcomed by Dr Brian Sweeney, consultant neurologist at Cork University Hospital (CUH). It was a good idea to have a centre focusing on those who may need surgery and it would be good to have rapid assessment, he said.
However, he emphasised that the centre would be complimentary to local epilepsy services around the State but would not replace them. Local services are still needed to give people equal access and to provide long-term care, he added.
Dr Tim Counihan, consultant neurologist at University College Hospital Galway (UCHG), also welcomed the proposed centre for the specific minority of epilepsy patients that would need them. However, he also said local services could treat the majority of epilepsy patients but they needed to be given the resources to do the best job.
Private investors will initially fund the centre and will be repaid under a capital allowances scheme, making it a charitable foundation after 15 years, Mr Geraghty said. The project has secured 60 per cent of the backing at this point and plans "are well down the road", he added.
The company is in ongoing negotiations with private health insurers and the HSE to arrange service contracts for patients to use the centre, he said. The centre will prioritise public and private patients based on their condition and history, he added.
A site has been identified for the centre in the Fingal area of Dublin, close to Beaumont Hospital, which is the main neurosurgery site in Ireland, Mr Geraghty said. Although an application for planning permission has not yet been submitted, it is being prepared, he confirmed.