David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I want to move to a third issue. Again, I want to stick with examples from University Hospital Waterford as I am familiar with it.

To ensure Mr. O'Brien was not blindsided, I signalled before the meeting that I would be putting this issue to him. I am trying to understand the relationship between policy, which he is not here to answer for as it is an issue for the Minister, operational matters and costs of funding. I have been following the process of the deployment of a mobile cath lab to treat cardiac patients at University Hospital Waterford for some time and am still unable to understand it. My understanding is that an announcement was made by the Minister in January that this would happen. A couple of weeks later, a business case was developed by the hospital management and sent to the South/South West hospital group. The group then sent it in January to the HSE, the Department or both. Four months later, nothing had happened and no decision had been made. At the time that the business model was developed, 580 patients were awaiting cardiac procedures at University Hospital Waterford. The hospital then entered into a service level agreement with hospitals in Cork and 380 of those patients are now being seen in Cork University Hospital, CUH, and a private hospital in Cork. If Mr. O'Brien will bear with me, I want to understand the process. At the time when the mobile cath lab was needed most, when the business case was made and the demand was greater, no decision was made. Even though it seems the Minister had made the decision, the hospital was not given approval to go to the procurement stage. The hospital has today stated it will be given that approval next week and that will then involve a procurement process. I am trying to understand the relationship between policy and decision making. Mr. O'Brien can correct me if I am wrong in my understanding. If the Minister were to make a policy decision that the deployment of a mobile cath lab could be one of several options used to reduce cardiac care, would it then be up to the HSE and the Department to make an operational decision as to whether that is necessary at any given time? Can Mr. O'Brien explain the decision-making process and who is responsible for what? I want to ask about procurement also. That is the real reason I am asking this but we will come to that presently. Can the witness explain the decision-making process?