Liam Twomey (Wexford, Fine Gael)

The cardiac catheterisation laboratory, cath lab, at Waterford Regional Hospital offers patients in the south east vital cardiology services such as coronary angiography, the provision of pacemakers and stents and implanting defibrillators in patients who suffer from a range cardiac conditions. The service has only been operational for three years. Prior to this, patients in the south east had to wait weeks to have these procedures completed in either a Dublin or Cork hospital. These treatments are well advanced. For example, in Dublin a heart attack patient will have a stent inserted into his or her arteries within three hours of presenting in hospital. The cath lab in Waterford may have to return to the old-fashioned treatment of giving clot-busting drugs instead if its times are reduced from five days a week to two, which would be a regressive move. Such a move would also discriminate against patients in the south east because there are no plans to reduce similar services in any other part of the country. Will the Minister for Health stop this move to reduce the laboratory's times which will put patients at risk?

This is one reason the Minister should get rid of the Health Service Executive, HSE, and change health service delivery. Under the old health board structure, health services in the south east were under-resourced. When the HSE was established, it was to ensure patients in every part of the country would have equal access to services. This policy has failed utterly. When it comes to saving money, the HSE goes for the soft option of closing down efficient services in the south east. The cath lab in the south east can be provided at a lower cost but with the same quality of care provided in a similar laboratory in Dublin. Patients in the south east are also entitled to the same access to such a service as patients in any other part of the country. Will the Minister insist on the HSE re-examining where it is reducing health services?

If the cath lab in Waterford is closed, patients will be lying on beds in hospitals in Kilkenny, Clonmel and Wexford waiting to be transferred by ambulance to Dublin. Not only will this lead to a waste of resources in hospitals in the south east but patients will also be put at increased risk of having another cardiac event. A patient not treated in a timely manner will be left with more damage to his or her heart muscle and overall health. The attempt to reduce hours at this cath lab shows the HSE is not fit for purpose. It does not think radically about how it can improve the delivery of services or patient care. It simply closes down services that are easy to close instead of going after overall wastage in the health service.

Has the Minister received a proper reply from the HSE on why this service has been reduced? This provides an opportunity to examine how health services are run. The HSE is closing down services willy-nilly just because it suits it. Government policy is to see money following the patient. We need to pay all hospitals fixed amounts of money to provide services relative to the population size they serve. For example, 500,000 people live in the south east. The cath lab in Waterford should be expected to perform so many procedures a year relative to a population of 500,000. It should, accordingly, be allocated a budget to enable it to do this. Additional payments should be made to hospitals which are more efficient and delivering quality care and low cost services in order that they can undertake more procedures.

Under the current system, hospitals or regions are given lump sums and informed that they should spend these moneys over the course of a year. When they run short of funds, they are told to simply cut services. That represents the worst form of management. I became very annoyed when I discovered that the service to which I refer is to be cut, particularly when people spent years fighting to secure it.

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