John Cummins (Fine Gael)
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I thank the Minister of State for taking this Commencement matter this morning. The need to expand cardiac services at University Hospital Waterford is a topic that we are both very passionate about. Along with Oireachtas colleagues past and present, we have both campaigned long and hard for it over many years. On the majority of items which affect Waterford and the wider south-east region, we all work collectively cross-party to advance these projects. I know the Minister of State and I would not have it any other way.

The general public and campaign groups have very much driven this issue and kept it to the forefront of everyone's mind. That is a good thing because the people of Waterford and the south east deserve equity of access to life-saving cardiac interventions in the same way as the people in other regions have. The Minister, Deputy Harris, approved the construction of the second cardiac cath lab at UHW at the end of 2018 against the advice of officials because he and the Government believed in the case being put forward by University Hospital Waterford, which was that in order to adequately treat patients in the south east in a timely fashion a second cath lab was required as the first step to expanding services which at the time only operated from 9 a.m. to 5 p.m., five days a week.

It was a painfully slow process to get to 4 September when the second cath lab opened. It was beset by many delays but thankfully we now have the second cath lab operational. There have been many vested interests in medical and other areas that did not and still do not want cardiac services expanded in Waterford. However, the political will and determination has superseded those vested interests and both those cath labs are now operational five days a week from 8 a.m. to 8 p.m.

The next step is to expand that service to operate from 8 a.m. to 8 p.m. seven days a week. I understand from both management at UHW and from officials that the final business case to expand those services has been submitted to the Department in recent weeks. I compliment all those who have worked diligently on putting that case forward. I recall a meeting which I hosted as mayor in 2016 when consultants stated that a service operating from 8 a.m. to 8 p.m. seven days a week would actually cater for 95% throughput of all PPCI cases. I am sure the Minister of State will agree that to reach that point would be a very significant development. To have it in place by the end of quarter 1 would be welcomed by all in Waterford and the south east.

Some in opposition have cast doubt, stating that the recruitment embargo would prevent the extension of cardiac services to seven days a week. I ask the Minister of State this morning to clarify the position with the current HSE recruitment embargo. What, if any, impact will that have on the extension of services? I understand that management has indicated to the Minister of State, the HSE and the Department that if it gets the approval in short order, it will be able to commence weekend cover by the end of March.That would be hugely welcome. Will the Minister of State clarify the position around the recruitment embargo and indicate the timeline within which that business case will be appraised and the decision notified to UHW management?

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for the opportunity to address the House on this important matter. I listened to what he had to say, and I read the response I am about to read yesterday evening. I suppose both of us could write the response at this stage. We have been invested in this with many of our colleagues for a long time. I commend the campaign groups, especially those with lived experience who have been through the process and understand how important it is.

I acknowledge the significant developments in cardiac services delivered by UHW and commend the staff on their continued commitment. The programme for Government contains a commitment in respect of the delivery of a second cath lab at UHW and funding was allocated in the 2019 capital plan for its provision. People might ask why we need a second one. It is because when you have one there is always a single point of failure if something happens. I am pleased to report the second cath lab opened on 4 September 2023 and is operating five days per week, Monday to Friday, from 8 a.m. to 6 p.m.

During the lifetime of the Government, considerable extra resources have been provided to increase the level of cardiology services at UHW. Prior to the opening of the second cath lab, a service-level agreement was in place with UPMC Whitfield to provide a three-day per week service to assist with cardiology diagnostic procedures in Waterford. This service has been replaced with the opening of the second cath lab in UHW, which provides a five-day per week service, a notable increase in the level of service provided to the people of Waterford. We now have two cath labs operating and the hours available are 8 a.m. to 8 p.m., Monday to Friday. Notwithstanding the difficult recruitment environment impacting the healthcare sector, the HSE has confirmed that the 24 healthcare professionals have been approved to support operation of the second cath lab. Twenty-two of these positions have been filled and a further two - two healthcare assistants - are currently filled on an agency basis. That is welcome. In addition, the opening hours of the first cath lab at UHW were extended in September 2022 and it is now open from 8 a.m. until 8 p.m., Monday to Friday. That is all progress, notwithstanding the fact progress has been slow. We have 24 extra staff in place, two cath labs and opening hours from 8 a.m. to 8 p.m.

The next phase, which is the subject of discussion today, is to secure weekend cover from 8 a.m. to 8 p.m. I guarantee the Senator that the political will is there. The Minister, Deputy Donnelly, has made it clear he supports a seven-day service and has recently given a commitment that the staff requirement for the additional Saturday-Sunday cover will be resourced from the 2,068 whole-time equivalents secured in budget 2024. In some areas there is a pause on recruitment. However, there will be no pause or embargo in relation to these 2,068 whole-time equivalents. The Minister has given a clear commitment. I understand UHW has submitted a business place to the South/Southwest Hospital Group for the additional staff required to extend opening hours. This is under consideration.

I spoke to the general manager in the hospital. I thank him for all his work and the support he affords us as Oireachtas Members. He said once the go-ahead is given to him, he will be able to stand this up quickly and be in a position that weekend cover could be provided by the end of March.

John Cummins (Fine Gael)
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It is important to reiterate some of those points. I do not think it is known by many people that 22 additional staff are already in place of the 24. These are additional staff over and above, as have been committed to in the 2,068 whole-time equivalent positions secured in budget 2024. I ask that an early decision be made on that. Notwithstanding the 22 positions being already in place, which will facilitate the quicker staffing of the seven-day week service, those additional positions will need to be backfilled. That takes time, given recruitment challenges, but the earlier they get the notification, the quicker the service can be stood up, which we all want.

Mary Butler (Waterford, Fianna Fail)
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It is important to reiterate those 24. For the second cath lab or any lab to open, you have to staff it. Twenty-four staff were funded. They are in place, 22 permanent and two agency, which is fantastic. We are seeing the fruits of that. Both cath labs are open five days per week and the additional hours this provides mean the waiting list for elective procedures in the cath labs is one of the lowest in the country, at under three months.

I have been informed that previously where an inpatient might have had to wait up to a week for a procedure, that is now happening within 48 hours. By having the extra capacity in the second cath lab, we are seeing the rewards, but we cannot take our eye off the main issue. Our next step is to get weekend cover. I look forward to working with the Senator on that.

Martin Conway (Fine Gael)
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I thank the Minister of State for taking the four matters. I know how busy she is. It is appreciated by us all in the Seanad. I also thank Senator Cummins.