Paudie Coffey (Fine Gael)
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I commend the committee on this work because it is a very significant national issue in terms of equality of access for patients to specialist care but more especially patients in the south east. Given what we heard in Dr. Herity's opening statement and his analysis regarding population and catchment, I want, with the Chairman's permission, to put on the record of the House some commitments that were given to me in writing by significant people in the Department of Health and the HSE. In February 2013, the architect of the hospital reform group, Professor John Higgins, stated in his report:

Waterford Regional Hospital will continue to provide invasive cardiology services for the South East population. Working in collaboration with the cardiology service in Cork the current service should be extended with new joint appointments of cardiologists.

On 13 May 2013, in a letter to me, the former Minister for Health, Senator James Reilly, stated:

The establishment of Hospital Groups will enhance cardiology cover in Waterford regional Hospital. At present, this is provided 9am to 5pm. The increased flexibility of staff across the group will enable us to achieve our goal of providing cardiology cover at Waterford Regional Hospital 24 Hours a day, 7 days a week.

On 14 April 2014, the CEO of the south east hospital group, Mr. Gerry O'Dwyer, wrote to me about interventional cardiology services stating:

The Cardiology Department of Waterford Regional Hospital is the regional service for 500,000 people and offers a comprehensive range of invasive and non-invasive diagnostic services including: E.C.G., Exercise Stress Tests, 24 hr. Ambulatory monitoring, Permanent Pacing and Follow up ... The provision of invasive cardiology procedures is both a clinical and political priority. It is essential that this service is located at Waterford Regional Hospital to serve the population of the South East.

Finally, I will read from a letter from the director general of the HSE who is still in situ. On 16 October 2014, in a letter to me, he wrote:

A business case has been prepared and was forwarded as part of the 2015 Estimates, for expansion to a twenty four hour service, seven days a week ... and the associated requirement for a 2nd Cath Lab. This will be re-examined in the 2015 Service Planning process.

He then goes on to speak about the costs.

My question to Dr. Herity about those very significant written commitments, which are now on the record of the Houses of the Oireachtas, is when he was doing his analysis of the population and catchment, were those same sentiments from the Department of Health, the HSE CEO of the hospital group and from the director general of the HSE made available to him in his analysis of the population and catchment? It is a critical and fundamental issue in this debate.

Regarding the throughput, Dr. Herity says University Hospital Waterford is below the minimum of 100 per year. I take it he takes that standard from the British Cardiovascular Intervention Society. Is it any surprise to Dr. Herity that it is below 100 a year when it is a service that only operates between 9 a.m. and 5 p.m., five days a week? Would he contend it would be in excess of the 100 per year throughput if it had a 24-7 service, which would then justify the requirement for that full-time service at that location? Will Dr. Herity answer that question? The standard referred to by the British Cardiovascular Intervention Society refers to where there are exceptions, such as where there is geographical isolation.

I strongly contend - as, I am sure, would other colleagues - that the south east is being treated in a geographically isolated manner in the context of the provision of this vital and critical service, which, for some, can mean the difference between life and death, and how people can access it.

Dr. Herity is an expert in his field and 90 minutes is often referred to as being the critical period in terms of cardiac care. He refers in his report to the fact that a patient can travel from Waterford city to Cork on the N25 within that 90-minute period. Has he ever driven from Waterford city to Cork city and, if he has, how long did it take? Is he aware that there are many bottlenecks on the N25, with which we are very familiar? I contend that it is impossible to reach Cork University Hospital from Waterford city in 90 minutes.