Stroke neglect - Life-saving treatment hit by red tape

The first three parts of a seven-part National Stroke Audit, commissioned by the Irish Heart Foundation, were published yesterday, presenting a frightening picture of our inadequacies in treating stroke victims.

Up to 9,000 people suffer a stroke annually and approximately 2,000 of those are fatal, which means that stroke is the third most common cause of death in Ireland. More people die each year as a result of stroke than the combined annual deaths from lung cancer, breast cancer and bowel cancer.

Tremendous advances have been made in this area of medicine with clot bursting drugs that can provide for a complete recovery, if administered within three hours. Yet there is only one stroke unit in the 37 public hospitals in the whole country, while just five other hospitals have partially developed units.

This compares dismally with stroke services in other EU countries.

By comparison, 91% of hospitals in Britain have stroke units. One-in-three Irish hospitals do not have access to a CT brain scanner, within 48 hours of a stroke, and two-thirds of hospitals do not have a consultant physician with specialist stoke knowledge. In addition, there are only 12 formal stroke unit beds available nationally. After factoring in the difference in population, there are more than 27 times as many beds for stroke patients in Britain.

Between 350 and 500 people could be saved each year if we had stroke units in our hospitals.

Professor Des O’Neill, chairman of the Irish Heart Foundation Council on Stroke, noted that more than 3,000 extra people lost their lives in this country as a result of stroke in the past decade, which could be compared with the total loss of life in Northern Ireland during the 30 years of the troubles.

There are also an estimated 30,000 people who survived a stroke. Some 6,000 of those are unable to walk again, while others have speaking difficulties or other impairments.

Thousands of people could be saved from such disabilities, if proper facilities were provided for stroke victims. Each hospital should have a stroke treatment unit, so that victims could be taken directly to that unit and receive the new clot bursting treatment promptly.

Instead, stroke victims are taken by ambulance to hospital, where they have to wait to be seen in Accident & Emergency units. By the time they get the necessary treatment, irreversible damage may have been done. This amounts to medical madness, administrative incompetence, and financial lunacy.

The money saved by not providing stroke units is more than lost in the aftercare of those who survive with impairments that could have been averted. Hundreds of millions are being wasted as a result of administrative ineptitude.

In the past, victims may have been taken to hospital by donkey and cart, but now with modern technology, we have motorised ambulances to get them to hospital.

But instead of getting modern life-saving treatment promptly, they get wrapped up in administrative red tape, and the service reverts to the era of the donkey. Only now, it seems that the donkeys are in charge of the health service.