Paucity of hospital stroke services highlighted

A "complete absence" of stroke services in Irish hospitals, in spite of the fact that stroke is the third most common cause of death in Ireland, was highlighted yesterday by the Irish Heart Foundation.

In its first national stroke audit, the foundation found that only one hospital in the Republic has a dedicated stroke unit. More than 90 per cent of hospitals in Britain have such a unit.

Stroke causes 2,000 deaths per year in Ireland, and the number of its victims over the past 10 years would fill Croke Park to capacity, the foundation added.

Despite this, the only public hospital with a dedicated stroke unit, understood to be the Mater hospital in Dublin, had only 12 beds catering for .03 per cent of stroke victims.

Almost one third of hospitals did not have routine access to CT brain scanning within 48 hours of the occurrence of a stroke, a crucial time for a positive recovery outcome, while thrombolysis services - the breaking down of blood clots using drugs - were not routinely available in hospitals.

While 81 per cent of hospitals had access to a generic rehabilitation unit, which could be used for stroke victims' recovery, two-thirds of these units were away from the main hospital site and had very low staffing levels.

Services for younger stroke victims were particularly poor with only five hospitals routinely accepting patients under the age of 65 into their rehabilitation units. The under 65s also had particular difficulties accessing community services, the audit found.

It also found that there was no specialised stroke care in the community and the generic rehabilitation services were of limited use for the long-term management of stroke patients.

The IHF noted universal concern among senior hospital staff about the availability of services.

Speaking in Dublin at the foundation's 10th annual stroke conference yesterday, its chairman Prof Des O'Neill said more than 3,000 lives had been lost in the last decade because of the absence of stroke care units.

"Availability of services of proven efficacy for those admitted to hospital with stroke in Ireland is very poor and in marked contrast to the current situation in the UK."

The availability of stroke services in general was limited and the considerable variation in access to services across the State was a cause of serious concern, Prof O'Neill said.

He went on: "In particular, lack of access to early CT scanning, acute stroke units and identifiable local lead persons with responsibility for developing stroke care need to be addressed as a matter of urgency. There is a huge need to invest in proper stroke units in Ireland. This will save lives and greatly improve patient outcomes."