Letter to the Editor: Access to care must be determined by need, not Eircode
Patients consistently described the burden of travelling long distances for care and the challenges of managing complex neurological conditions without access to appropriate local supports.
Dear Editor,
As discussions begin around Budget 2027, there is an opportunity to address a growing challenge facing Ireland's health service and the more than 860,000 people living with neurological conditions across the country.
Neurological conditions affecting the brain and spinal cord, now affect one in six people in Ireland.
Yet despite rising demand, access to specialist neurology and neurorehabilitation services remains unequal and, in many cases, inadequate.
The Neurological Alliance of Ireland's recent report, Towards an Equitable Integrated Neurology Service for Ireland, highlighted significant shortcomings in neurology services 10 years after the publication of the National Model of Care for Neurology. Neurology waiting lists have doubled over the past decade and now exceed 24,000 people. Many patients continue to experience lengthy delays in accessing diagnosis and treatment, while others must travel significant distances to attend appointments because services are not available locally.
Perhaps most concerning is the extent to which access to care depends on where a person lives. Our research found significant regional disparities in access to specialist neurology services, with some Model 3 hospitals still lacking dedicated neurology services despite longstanding national policy commitments. Patients consistently described the burden of travelling long distances for care and the challenges of managing complex neurological conditions without access to appropriate local supports.
Alongside timely diagnosis and specialist care, rehabilitation plays a critical role in helping people maintain independence, remain active in their communities and avoid unnecessary hospital admissions. Yet significant gaps remain. The South East is currently the only region in Ireland without a funded community neurorehabilitation team, despite a commitment in the Programme for Government to complete the nationwide rollout of these services.
These are not simply healthcare issues; they are quality-of-life issues. Delayed diagnosis, limited access to specialist care and a lack of rehabilitation support can affect a person's ability to work, study, care for family members and participate fully in their community. The impact is also felt by families and carers who often shoulder much of the burden when services are unavailable.
The good news is that practical solutions already exist. The Government has committed to strengthening neurology services and completing the rollout of community neurorehabilitation teams. What is needed now is the investment required to turn those commitments into reality.
In its Pre-Budget Submission 2027, The Right Care in the Right Place, the Neurological Alliance of Ireland is calling for targeted investment of €2.2 million to strengthen regional neurology services, support specialist pathways for timely diagnosis and treatment, and fund the long-promised community neurorehabilitation team for the South East.
These are modest but important investments that would help address longstanding regional inequalities, improve patient outcomes and reduce pressure on acute hospital services.
For the one in six people in Ireland living with a neurological condition, Budget 2027 presents an opportunity to ensure that access to care is determined by need, not Eircode.
Yours sincerely,
Magdalen Rogers
Chief Executive
Neurological Alliance of Ireland
