In Ireland, the field of neurology is at a critical juncture. On the plus side, we lead the way in neurological research. For example, FutureNeuro, launched in September, is a world class research centre supported by Science Foundation Ireland, focusing on chronic and rare neurological diseases. Its location makes perfect sense, too, because Ireland is uniquely placed to be a European leader in the area of brain research, thanks to our high calibre of internationally recognised clinicians and scientists, our small size and our highly networked population. We are also a leader in health innovation.

It was Irish clinicians who designed, developed and implemented an electronic patient record (EPR) for epilepsy patients — technology that is now being used to advance e-health, genomic sequencing and data analytics.

Neurology also has some of the most innovative patient organisations in Ireland, informing, driving and supporting research, designing self-management programmes and assistive technologies, and designing and delivering services in response to patients' needs.


Challenges facing Irish neurology


Frustratingly, however, neurology faces immense challenges, too. As a clinical service, it is creaking at the seams with staffing at critical levels: we have one of the lowest numbers of consultant neurologists and multi-disciplinary specialists in Europe.

Our ongoing A&E crisis means that patients are often not admitted to neurology units because beds are simply unavailable; and those wonderful patient organisations are increasingly facing dramatic cuts and an alarming lack of understanding about the vital services they provide.

Then there is another worrying issue: giving patients speedy access to diagnostics. Take MRI scans, which are necessary to diagnose many neurological conditions. The demand for this service — and its lack of expansion in the public health system over the years — means that waiting times are getting longer and longer.


Dealing with increased demand


The fact is that neurology is facing a huge increase in demand, probably more than any other discipline in Irish healthcare.

Perhaps this shouldn't be a surprise. We have an ageing population, after all, with increased numbers of people needing treatment for conditions such as Parkinson's disease, stroke and dementia, which is putting an immense strain on the system. And when you have a service where demand is growing but investment is static, something has got to give.

The key, of course, is funding. Incredibly, this area of medicine has suffered from a historic lack of investment — but that must change – now – if neurology is to realise its vast potential while being properly equipped to deal with current and future need. What this particular discipline requires is sustained investment over a long period of time. Our people demand it and deserve it. And we, as a country, are going to need it.