Dr. Aidan Buckley:

I am a clinician who works part of my time in Waterford and the bulk of my time in Wexford. Wexford is the most geographically isolated part of the south east. We are outside the so-called golden 90 minutes all of the time if Waterford were to close for primary PCI. We will never be inside that 90 minutes. Currently, we have access for primary PCI from Monday to Friday, 9 a.m. to 5 p.m. If one is fortunate or unfortunate enough, as the case may be, to have a heart attack during those hours, one will have one's primary PCI performed in Waterford. If it happens outside those hours, one will be put in an ambulance and brought to one of the Dublin hospitals. Under Dr. Herity's recommendations, that 9 a.m. to 5 p.m. service will be taken from us altogether, so we will have 100% of nothing. He alludes to the point in his report that perhaps some type of arrangement could be made to transport these patients faster.

The Deputy spoke about the optimal reperfusion protocol. That is a misnomer because it is a sub-optimal treatment. Thrombolytic therapy, which is the old-fashioned way of dealing with heart attacks, is an inferior treatment. That is not my personal opinion, but has been proven in trial after trial. We are now saying it is acceptable for the people in the south-east region to have an inferior treatment and then be shipped on for delayed treatment in one of the centres in Cork or Dublin. If the same logic were to be applied to Castleknock or Montenotte, I doubt that we would be having this conversation. The same should apply to the people of the south east. They should have access to optimal treatment in the real sense.

The Deputy asked about emergency and elective or planned work. There are two parts to emergency work. There are the acute heart attacks, or the code STEMIs, and the patients who come to the hospital with undiagnosed chest pain. They might not have a heart attack but a condition called unstable angina. When the catheterisation laboratory first opened in Waterford we were able to provide a very timely service for angiography for these patients, because it was building up. However, as the volume of referral increased the capacity was outstripped. Now we have the scenario where patients who come to Wexford hospital with undiagnosed chest pain who require angiography must now wait a week to ten days in hospital. This is a matter of public record in terms of data from Wexford about inpatient stays for people with acute coronary syndromes. These are people who are not having acute heart attacks but who have had chest pain that remains undiagnosed. They are occupying a hospital bed for ten days. The internationally recognised timeframe in which these patients should have angiography is 24 to 48 hours, at most. We are far away from that now because these patients cannot access the care they need in Waterford. Let there be no doubt about this - going to another hospital in Dublin or Cork is not an option. We ring these hospitals daily. There are no beds, as anybody who has been listening to the news in the last few months knows. They cannot take our patients, so it is not an option for the people of Wexford. Waterford is our only option. This is not emotion. It is reality.