IF PROPER stroke services aren't provided across the State, the Government could end up facing legal actions from patients who don't receive appropriate care.
The warning came yesterday from Dr Brian Maurer, medical director of the Irish Heart Foundation, after it published a national audit of stroke services showing only one hospital in the country, the Mater in Dublin, has a fully resourced stroke unit.
Care in these units reduces death and disability by 25 per cent and could save around 500 lives a year.
The audit also found only 1 per cent of patients are being assessed for clot-busting thrombolysis therapy, which if given within hours of a stroke, can be effective in reducing disability in those patients whose stroke has been caused by a clot rather than a bleed.
Dr Maurer said the prospect of legal actions by patients not offered such standards of care in all areas was a "hazard" the Government now faced unless it took urgent action to improve services in line with best practice.
Prof Des O'Neill, a consultant geriatrician and one of those involved in the stroke audit, agreed that legal actions were "a possibility" that couldn't be ruled out. He said people had already sued in the US because they hadn't got thrombolysis therapy.
Elizabeth Roe, a mother of five from Dundrum, Dublin, who suffered a stroke while on a cruise in the Mediterranean in October 2006, explained how she was immediately airlifted by helicopter to a hospital in the south of France, had an MRI scan and was given thrombolysis within hours.
She had initially lost the power down the right side of her body but has made a full recovery. "If I'd had the stroke here and lived I'd have ended up on a wheelchair," she said.
Meanwhile, Prof O'Neill called for the lifting of the health service employment ceiling in the area of stroke care.
He said he was aware of up to seven hospitals that had planned stroke units but they couldn't be opened because of the HSE employment ceiling.
He said Tallaght Hospital had been seeking a small number of extra nurses for some years to bring its services to the level of a stroke unit but they weren't provided.
Minister for Health Mary Harney said her department has met the HSE on the issues raised in the audit and that it is already working to enhance the provision of acute hospital services to stroke patients.
The HSE claimed there had been a number of "service developments" since the researchers collected data for the audit. It said it was finalising an evaluation of its stroke services. "The evaluation has so far identified 14 hospitals where stroke services have begun to be developed," it said.
It added that it will be publishing the details of this evaluation in the next few weeks.
Labour's health spokeswoman Jan O'Sullivan said the audit highlighted glaring deficiencies that stroke victims and their families are forced to endure. She called on Ms Harney and HSE chief executive Brendan Drumm to appoint a working group, tasked with coming up with a speedy plan of action to improve services.