Madam, - Stroke is the commonest cause of serious acquired disability in adults, and kills more people in Ireland than any single cancer. Effective and properly resourced treatment strategies in stroke units for transient ischaemic attacks (TIAs or "warning strokes") as well as strokes are proven to be highly effective, both clinically and in terms of cost. Adequate funding for these services will lead to reduced hospital admission rates, shorter hospital stays, lower levels of avoidable disability, fewer admissions to nursing homes, and substantial cost savings during the current recession.
As stroke care is estimated to cost the Irish Health Service €100 million in 2008, support for these internationally proven services should be provided urgently by the HSE. The universal introduction of stroke units could save approximately 300 to 500 lives, reduce length of stay in hospital by 20 per cent, save over €15 million, and reduce nursing home bed needs by 350 each year. Emergency thrombolysis (clot-busting) treatment for 10 per cent of patients with stroke in such units could improve or prevent disability in over 400 patients, and save approximately €7 million a year. Same-day rapid access to specialist TIA clinics across the country could avoid over 1,000 hospital admissions, and prevent approximately 200 strokes in 2009.
The Irish National Audit of Stroke Care(April 2008) showed that all these services are very poorly developed in Ireland, with only one complete stroke unit in 37 hospitals, and only 1 per cent of stroke patients receiving clot-busting treatment at the time of the audit. It is a cause of intense frustration to patients, families and professionals that these services, whose efficacy has been recognised for over a decade, have not been developed, despite strong advocacy.
As members of the Irish Heart Foundation Council on Stroke, we are concerned that the HSE Service Plan for 2009 makes no overt reference to either stroke development, nor to the almost completed report of the Cardiovascular and Stroke Working Group.
On behalf of the 40,000 survivors with stroke in Ireland, and the 10,000 who will be affected by a new stroke in 2009, we request that the Department of Health and Children and the HSE work together with health professionals urgently to implement the development of, and enhancement of, modern stroke services in Ireland in 2009. Hundreds of lives will be saved, significant disability and institutionalisation will be averted, and in terms of "value for money" (a key element of the HSE service plan), a major efficiency will be introduced into the Irish health system. - Yours, etc,