“It is time for change. It is time for a revolution in rehabilitation.” Not our words but those of the person appointed by the Government of Ireland and the HSE as the National Director of Clinical Strategy and Programmes, Dr Áine Carroll. (Irish Examiner, 03.02.2011)

The National Rehabilitation Hospital (NRH), the only facility of its kind in the whole of Ireland,  has just 119 in-patient beds. “Ireland should have a minimum of 372 in-patient rehabilitation beds,” said Dr Carroll. The doctor stressed that rehabilitation following injury or disease was a basic human right. It was not a privilege and was supported by international legislation.

Dr Carroll states, “There are insufficient numbers of rehabilitation medicine consultants, insufficient access to specialist rehabilitation at a local level, lack of support for primary care teams in managing very challenging cases and lack of support for the patient and their families. Even if a patient has been through the services of the NRH, once they get discharged they’re very often left in a kind of limbo.” – Dr Carroll admits that the number of rehabilitation medicine consultants – six full-time and one temporary – is grossly inadequate for a country like Ireland, which has the lowest number of rehabilitation specialists in Europe per head of population.

“I do not enjoy the frustration of being embarrassed when we tell our European colleagues how little rehabilitation resources we have in our country,” Dr Mark Delargy, Medical Director of the Acquired Brain Injury Programme at the National Rehabilitation Hospital (NRH) remarked. “The challenge is getting patients without having to wait months and months and our challenge is to accept people with the most severe disability quicker than we are doing. “People with the most severe disability require the most intensive resources, but our capacity to admit patients with the most severe disability is limited so we have a bed quota for people in a vegetative state and with locked-in syndrome.”

All this is a bit long and maybe complex – if you feel like it: the full text and sources are here. Compare the above with the recent reports published in the context of Pádraig’s case. The situation is ’embarrassing’ (M. Delargy) and ‘grossly inadequate’ (A. Carroll).

Today, Pádraig had a bit of a lung congestion. Nothing serious, but he could do without it. We are discovering how nice it is to be able to close the door and to just be with him. No need to talk. No need to do things. Just be there. In between, we are telling him about what is going on back home: the concerts, the table quiz, the swim, preparations for a ‘mini’ marathon. He would probably be very embarrassed if he did grasp and understand what people are doing to help him. There are literally hundreds of people preparing concerts with more than 10 bands and musicians, quizzes, running and swimming events. I can only imagine how much he would like to be right in the middle of it all. – One day he will be!

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