The Treatment and Care available for Epilepsy in Ireland

 

a. There are currently 40,000 people with Epilepsy in Ireland.

The current census shows a population of 4,234,925 in Ireland and increase of 8.1% since 2002 ( the largest ever increase record of such a period).

 

b. Currently there are 17 publicity appointed consultant neurologists in Ireland.

(Four with specific expertise and four others in private practice).

 

c. Therefore the current ratio of Consultants Neurologists per head of population is 1 per 259,000. 

 

This is the highest ratio of western countries including:

UK: 1 per 164,000

Belgium: 1 per 71,000

Japan: 1 per 63,000

Germany: 1 per 41,100

France: 1 per 39,300

Sweden: 1 per 30,500

USA: 1 per 26,200

Holland: 1 per 25,100

Greece: 1 per 21,200

Finland: 1 per 20,200

Iceland: 1 per 15,500

 

Ideally in Ireland we need to have a ratio of 1 per 100,00

 

d. The huge shortage on Consultant Neurologists in Ireland has led to a lack of adequate resource across the spectrum of multi disciplinary expertise. This significantly impedes on a timely delivery of optimum Epilepsy care in Ireland relevant to both the public and private sectors..

 

e. The impact of this means that there is a waiting time of up to two years to see a Consultant Neurologist which impacts not just on diagnosis but also ongoing monitoring of a persons condition. In addition it can take a minimum of five years of surgical analysis to be considered.

 

f. There is also a lack of dynamic planning for the evolving and future needs of the population. Changes in demographics are also being ignored.

 

g. The Comhairle na aOispidéal 2003 Report on the Irish health service (including it's compliance with European Working Times Directive in the provision of health services) concluded the following in relation to Neurology services in Ireland.

- That a team based consultancy service is the only way forward to ensure the highest quality of safe patient care.

- The system is overly dependant on doctors in training and that patients currently have limited access to appropriate levels of senior clinical decision making which has serious implications for both diagnosis and treatment.

- The report also acknowledged a need for 'single speciality hospitals', for certain areas of treatment, which given financial and logistical implications must be a long term goal and should be considered as part of an overall plan.

 

i.  The report also recommended the following levels of Neurologists and Neurophysiologists for 2009 and 2013;

 

Neurologists:

In 2003 there were 14 in place.

By 2009 it recommended 34 ( 1 per 115,000 head of population)

Currently there are 17 ( 1 per 259,000 head of population)

 

Neurophysiologists:

In 2003 there were 3 in place.

By 2009 it recommended 14 points

Currently there are 4 positions in place.

There are none in place for paediatrics.

 

In conclusion the following points should be remembered:

- Epilepsy is commonplace in Ireland (40,000 cases).

- There is a major shortage of neurologists, Epilepsy specialists and other professionals involved in the care of individuals with Epilepsy.

- There should be 34 consultation in placeby 2009 and currently there are only 17.

- Waiting times of up to two years and beyond is the norm, just to be seen by a consultant specialist. This extends to five years of surgery.