My office has been inundated with demands for a dedicated outpatient neurology service provided by a consultant neurologist at Letterkenny University Hospital. The community neurorehabilitation team in the north west is seriously understaffed and operating with only one third of the required number of staff. This will not change until the HSE's recruitment embargo is lifted. That recruitment embargo was brought about by Government underfunding of the health service. Is it not time for better neurology services to be delivered for the people of Donegal and the north west? If so, what will the Minister do about it?

I thank the Deputy. With regard to the recruitment embargo, there is definitely a debate to be had about funding of the health service, but the recruitment embargo had nothing to do with this issue. In fact, the HSE was funded to a record level last year for an additional 6,000 staff but hired in excess of 8,000 staff. I do not want the recruitment embargo to be in place but this particular issue is not a funding issue, though other matters which we have discussed previously are related to funding.

I asked my Department to contact Letterkenny University Hospital to understand exactly from the hospital's perspective what it is that it is looking at. At the moment there is an outreach service for neurology into Sligo. The service is operated by three neurology consultants. There is a wider team of clinical and social care staff. The diagnostic work-ups and treatment are delivered from Sligo at the moment but, as the Deputy stated, there is a demand locally in Donegal for neurology services to be provided not in Sligo, but in Letterkenny.

To that end, there is an ongoing review of neurology services in the north west that is scheduled for completion in the coming months, in quarter 3 of 2024. I have asked my Department and the HSE to be very cognisant of what people in Donegal are saying and what the neurology teams in Letterkenny University Hospital are saying. We need to let that review run its course and see what recommendations come from it. If there are recommendations to increase the neurology capabilities in Letterkenny as well as in Sligo, we will look at them very seriously.

I accept that Letterkenny University Hospital currently provides clinics for patients with neurological conditions but it urgently requires a dedicated outpatient neurology service provided by a consultant neurologist. This is not the first time I have raised this issue with the Minister. He previously informed me the review of the neurology services in the north west was under way. The difference is that the review was supposed to have been completed by now. The last time the Minister told me about the review, it was supposed to be completed in quarter 2 of 2024 but now it is to be completed in quarter 3. All of this time, people in my county are being denied this service. According to the information the Minister gave me previously, the review should have been completed by now. He has just told me it will now be another three months, possibly four months, and maybe it will slip a little further.

The Department was informed of the issues with neurology services a long time ago. I believe the Minister sat on his hands. People have to travel to Sligo for treatment and, for many people, that is a significant distance. It is a 300 km journey for people who should have services provided more locally to them. Why has the review slipped? Why is there new information now that puts this review back further? Has the Minister asked why the review has not been completed at this stage?

I will ask the Department to revert to the Deputy directly on the delays and the date for completion of the review moving from quarter 2 to quarter 3. Let us see whether that delay can be managed down to just a matter of weeks.

This is not about the denial of any service. The service is being provided but, as the Deputy reasonably pointed out, it is a long way to Sligo University Hospital for many people living in Donegal.

The review is nearly complete. Let us get the review and see what it recommends. It may recommend a neurology post or two in Letterkenny University Hospital or a team that moves between Sligo and Letterkenny. Let us see what the review comes back with. We will take that recommendation very seriously and can look at doing it through new development funding.

It is not acceptable to make neurology patients travel so far. The campaign group Patients Deserve Better has outlined the impact of this, including the increased costs and waiting lists, as well as unnecessary hospital admissions when services are not provided locally. It is not just the campaign group, however. The HSE model of care report suggests there is a need for a consultant neurologist to provide neurology services at Letterkenny University Hospital.

This is just another example of Letterkenny University Hospital being in a perpetual state of crisis. Waiting lists for diabetes care have gone through the roof, with a range of unfilled vacant posts. In an unprecedented move last year, 100 GPs signed a public letter to the Minister and to consultants, saying that the hospital's emergency department was unsafe. There are huge waiting lists in dermatology services due to unfilled posts. Letterkenny University Hospital cannot go on like this. It is leaping from crisis to crisis. It needs further investment but, crucially, it needs to be upgraded as a hospital. That is abundantly clear and it is one of the main reasons we cannot recruit people into positions. It seems as if I could raise another crisis at Letterkenny University Hospital with the Minister every week. This issue needs to be dealt with in its entirety. The upgrading of the hospital is probably one of the steps that need to be taken without delay.

The reality is that although there are ongoing pressures on certain services at Letterkenny University Hospital - I fully accept that and have visited the hospital many times - there has been a very significant increase in capacity in the hospital and in services delivered by the hospital in the lifetime of this Government. The budget has increased by a quarter. The number of staff has increased by a quarter, growing by 437. There are 437 more healthcare workers working in that hospital compared with when the Government came into office. That is a very serious statement of intent of investment and growth for the people of Donegal and Letterkenny. Probably most important, the Deputy will have seen the new beds plan. Between the beds we have delivered and the extra beds we have now committed to, we are looking at an extra 122 beds at Letterkenny University Hospital. Do we need to continue to focus on the ED? We do. Do we need to continue to focus on the neurology, oncology and diabetes services the Deputy and I have spoken about? We do. I want the people of Donegal to be very clear that there is much-deserved, much-needed and very important ongoing investment and growth in Letterkenny University Hospital