The long waiting times patients have to endure to access neurology services in the Republic are forcing some people to travel abroad for treatment, according to a new report.
The report, which is a review of neurology and clinical neurophysiology services, says that while people who are suspected of having a neurological condition such as multiple sclerosis should have prompt access to specialist neurological expertise for an accurate diagnosis and treatment, patients can wait a year or more to be seen.
The report - which was submitted to the HSE's National Hospitals' Office last month and which has been seen by The Irish Times - states far more specialists need to be appointed, and the services which exist need to be reorganised and delivered through four managed clinical networks, one in each of the four HSE regions.
It notes that estimates put the number of people with a neurological condition in the Republic at more than 700,000 and "demand for care outstrips supply". Demand for services is also increasing as the population ages. It adds: "The service is largely hospital-based, and it is overloaded."
Furthermore, it says "there are major weaknesses in the way the service is delivered", and patients with neurological conditions are often admitted to hospital but never see a neurologist.
"There is a large variation in the availability of neurology services around the country, with unequal access and long waiting lists for diagnosis, treatment and care."
Consultant neurologists working in the system were consulted for the review, which was chaired by Dr Marie Laffoy, assistant national director of strategic health planning with the HSE.
One Dublin neurologist is quoted as saying a patient recently arrived at their clinic one year early such was the long lead-in time to appointments.
Another unnamed Dublin neurologist is quoted in the report as saying: "Some patients travel to other countries to see a neurologist because of the delays here - I know of one patient who was seen in Stuttgart and another who was seen in Scotland."
The report states staff working in neurology services are in danger of becoming demoralised because they are under significant pressure.
It says 42 neurologists should be in place to treat adults and a further 12 should be available to treat children. However, at present the numbers fall far short of this recommendation.
GPs were also asked for their opinions on the current state of neurological services. Some 70 of the 85 GPs who responded said they considered access to specialist neurology services "poor".
Almost 60 GPs cited the appointment of more consultant neurologists as the most important step that could be taken to improve services.
Neurological conditions would include epilepsy, stroke, migraine, Parkinson's disease, motor neurone disease, multiple sclerosis and dementia.
The executive is considering the report.
Neurology review: main points
• There are major weaknesses in the way in which neurology
services are currently delivered. There is a lack of integration
and real multidisciplinary care.
• Demand for care outstrips supply.
• There is a huge shortage of neurologists.
• There are long waits for assessment and access to
care is inequitable across the country and even across Dublin
postal districts.
• The service is largely hospital based and is
overloaded.
• The high-quality staff working in the area are in
danger of becoming demoralised unless services are better
resourced.
• GPs are generally unhappy with the way in which the
current service operates.
• The way Ireland delivers neurology care is not
sustainable and the structure and system need to be radically
overhauled. It is recommended neurology services in the State
should be delivered through four managed clinical networks in
future, one in each of the four existing HSE regions.
• New neurologist appointments should be to these
networks rather than to a specific institution.
• Each of the four networks should be self-sufficient
for general neurology services.