Lifestyle Health

Wednesday 21 February 2018

Top neurologist warns targets are preventing care

Professor Orla Hardiman .
Professor Orla Hardiman .
Eilish O'Regan

Eilish O'Regan

A LEADING neurologist has warned that waiting list targets are damaging doctors' ability to take care of patients with illnesses such a multiple sclerosis.

Prof Orla Hardiman of Beaumont Hospital in Dublin said "the HSE has asked to prioritise new patients and to reduce the numbers of patients returning to our clinics.

"But at the same time, we are under greater pressure to follow return patients as their disease progresses, particularly those on expensive disease modifying therapies that require surveillance for example multiple sclerosis.

"We are now required to re-issue hi-tech prescriptions every 6 months. How can we do this if we cannot review the patients receiving these drugs."

She was appearing before the Joint Oireachtas Committee on Health and Children to highlight the ongoing problems faced by patients with brain diseases.

Prof Hardiman told the committee that "reducing waiting lists is very important. Nobody should have to wait for 9-12 months of a specialist opinion.

"Part of the problem is that the number of available neurologists, and other professionals such as nurse specialists is still lower than it should be for the size and expectations of our population."

For many patients, attending the neurology clinics in hospital are the only way by which they can continue to access any sort of service that is relevant to their needs.

"We would like you to recognise that one size fits all does not work in neurology. Our role in continuing to care for people with chronic progressive condition must be valued. In neurology, the return patient should be recognised as equally important as the new patient in the HSE metric."

She told the committee: "Of course, we need to reduce waiting lists, but the policy of excessive prioritisation of new patients over return patients, as required by the HSE is bad for our fellow citizens."

She added: "We recognise that our models of care are changing. Some of the shortages in neurologists could be addressed by building capacity in collaboration with other professional groups.

"And we have had some major successes in this regard, as evidenced by the epilepsy programme where the model of care includes highly trained nurse practitioners with extensive clinical expertise. But for us to provide a responsive, cost effective and valuable service, we need joined up and thinking with a strong emphasis on accountability within the HSE.

"We must remember that there is a continued role for specialist clinics in hospitals, while at the same time we must strive to build really effective multidisciplinary neurorehabilitative services that are both patient-centred and that link expertise within the hospitals with high functioning neuro rehabilitative service within the community."

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