Dr. Patrick Owens:

As far as the high-volume issue is concerned, that is subject to interpretation.

In 2016, we did just short of 1,000 PCIs, which is a large volume by Irish standards and would certainly be up there with other units. The specific number, for the record, is 805. I suspect what Dr. Herity may be referring to is high-volume centres for primary PCI. Primary PCI, for clarity, is PCI for the acute heart attack and that is a very small percentage of the total work we do. The current recommendations are that the bare minimum a unit should be doing is 100 primary PCIs per year, although I understand that there may be moves to increase that number. In terms of the 100 value, we did 75 in 2016 out of total of 102 code ST-elevation myocardial infarction, STEMI activations. In other words, 102 patients were flagged as needing to get into the unit, 75 of whom ended up having heart attacks and stents. Some of those 102 patients would have had other diagnoses. Those figures arise at a centre that is working from 9 a.m. to 5 p.m., Monday to Friday. Clearly and self-evidently, if we were operating on a 24-7 basis, the figures would be far higher. We would certainly be in excess of the 100 minimum and the 150 minimum. Those are the current definitions and we would exceed them comfortably if we were operating on a 24-7 basis. The criteria for the minimal standard set would be achieved.