Ms Kathryn Reilly:

I will briefly touch on that. The lack of a comprehensive national cardiovascular health policy is detrimental because such policies provide the overview and the impetus from the Department of Health itself. They facilitate planning and prioritisation. Many of the problems we have in terms of the stroke strategy stem from the fact that there is no comprehensive policy to begin with. The policy that was in place until 2019 dealt with the broad spectrum of services from prevention to rehabilitation and everything in between, including the acute services. The national review of cardiac services, whose publication we are awaiting, only deals with one subset of that. The stroke strategy is one subset of that. When you do not have a national policy or, indeed, a designated official within the Department to drive that, there are a lot of problems. There are problems in terms of the implementation in the HSE because we do not have that impetus, someone to drive it forward and something to be accountable to.

In terms of the lack of publication of the national review of cardiac services and what it means for services and even for us, we know from cardiologists and from the clinical advisory groups on different subspecialities that they cannot plan or prioritise. They have provided documents that set out the resource requirements. Until that review of cardiac services is published, they cannot drive forward with looking for the resources required.