David Cullinane (Waterford, Sinn Fein) | Oireachtas source

Okay. it should be noted that it was put to Dr. Herity that he had a responsibility to consult with people if he so wished and it was not the case that he should have to expect people to come. In any event, the witnesses have clarified that they were not even informed that this day of consultation was happening. I have tried to condense the report down into very simple language and a simple proposition because we could overly complicate this, but essentially Dr. Herity's main proposition is that there are two distinct sets of patients in the south east, the patients who need planned work and those who need emergency work. I also asked him if he had ever worked in, or been responsible for, a hospital or unit that has one cath lab, and he said "No". Obviously he had to do a piece of work for the south east and specifically for the University Hospital Waterford.

Dr. Herity's whole logic is that it is not possible for a single hospital with a single cath lab to do both planned and emergency work. It is not possible and this is why he recommended that all emergency work be outsourced to Cork so that University Hospital Waterford would not do any emergency work on any day of the week. All of that work would be transferred to Cork. People in Tipperary, Carlow and Kilkenny who would have gone to Dublin would continue to go to Dublin, and all of those in Waterford city and its hinterland would go to Cork. Waterford University Hospital would specifically deal with all planned cath lab work. Given that one cannot divorce implementation from the recommendations, it is also the case that the Government, the hospital and the south-south west hospital group have decided that University Hospital Waterford will continue to provide 9 a.m to 5 p.m. emergency cover. On the basis that Waterford University Hospital will continue to provide PCI cover Monday to Friday, and all the planned work that it already does, Dr. Herity conceded that this was not viable. His recommendation is that emergency work was to be shipped out to Cork.

We have heard from Dr. Herity as a clinician, and nobody is doubting his integrity, experience or work in this regard - I certainly did not doubt it and I am sure the witnesses have not. The witnesses here are also cardiologists and clinicians with experience. Dr. Herity's proposal is now not happening because, thankfully, Waterford will now maintain its 9 a.m. to 5 p.m. PCI cover at least but we want to go beyond that. In the witnesses' opinion is it sustainable for the University Hospital Waterford, with one unit and one mobile lab, to do both the planned work and the emergency work in the future even with the effective population criteria that he proposes? Is this feasible and possible?

Me second question concerns the scenario if the recommendation had been to not look at the effect of population criterion but to look at the entire south east with patients from Kilkenny, Wexford or Tipperary who are being transferred to Limerick, Cork or Dublin. If Waterford University Hospital had a second lab - we are moving towards enhanced services - would it be feasible for these patients to be referred to Waterford University Hospital? Would this increase the patient throughput into University Hospital Waterford? I know this is in two pieces, but can the witnesses understand the logic of it? The logic of the report is that one cannot do both, it must be one service or the other, in Waterford with one lab. That is now not the case so would the witnesses agree with Dr. Herity that it is not feasible in the first instance? Given that it is now the case, if we had a second lab, do the witnesses believe in their own professional opinion and the opinions of those who work in the south east, that patients who are currently being diverted elsewhere, would be referred to University Hospital Waterford?