Dr. Niall Herity:

There were three questions there. As I recall them they were on clinical risk, the number of patients referred out of hours and whether more patients would come if there were more capacity. On the last question, I would make no assumption that would be the case. The reason is that the referral patterns of cardiologists or other specialists to specialist centres focus on many different aspects. I am a referral cardiologist and a referring cardiologist so I know exactly how this works. Much of it has to do with where those cardiologists practise their cath lab sessions. In the case of south Tipperary and Wexford, naturally the patients follow them to Waterford because that is where they have their cath lab sessions. Similarly for patients from Carlow and Kilkenny, naturally those patients gravitate towards St. James's Hospital in Dublin because that is where the cath lab sessions are. The patterns also reflect many years of experience of how good a service has been received from the various options that they have referred patients to and, indeed, long-standing interpersonal and interprofessional relationships. I would not jump to an assumption that, if capacity were suddenly to change or to double, patient referral patterns, or so-called patient flows, would necessarily and automatically also follow.

I want to answer the Deputy's very specific-----