Dr. Tony O'Connell:

The issue with Waterford is the challenge of having an adequate number of consultants to provide the service. The acute coronary syndrome programme suggests that to have a 24/7 service certain criteria must be met. These include a critical mass of patient population and a critical mass in terms of consultant manpower with a minimum of five wholetime equivalent consultants and two cath labs. It is for that reason the programme designated six 24/7 services in Ireland, three in Dublin and one each in Cork, Galway and Limerick. The challenge in Waterford is that there are three consultant interventional cardiologist posts at the hospital and they are supported by two visiting consultant cardiologists from Wexford and South Tipperary, each attending one day a week. Due to a recent transfer, only one of the three posts is filled permanently while two are filled on a temporary basis pending two permanent appointments by 1 September next year. There is a challenge to consistently maintain the critical mass of consultants to deliver the service in a high quality and safe manner. The hospital is examining proposals to extend its service. Currently, the service is a five-day service from 8.30 a.m. to 5.30 p.m. Clearly, challenges with having enough consultants on the roster mean it may not be possible to maintain that roster consistently.