Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank the Deputy for raising this issue. He is correct about everything he said. It is not just an Irish problem, but, indeed, an international problem. Europe does well when member states do things together. World Heart Day was founded in 2000 to inform people about heart disease and its prevention. This year the theme is creating heart healthy environments. The day is intended to spread awareness that premature deaths from cardiovascular disease can be avoided if the risk factors, including tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol, can be controlled. I am sure the Deputy heard all about this yesterday. Healthy Ireland provides a framework that supports heart healthy environments. It includes strategies on tobacco and alcohol. The Department is currently revising its healthy eating guidelines and is developing an obesity policy and action plan, which will be finalised this year. The Department's Changing Cardiovascular Health: Cardiovascular Health Policy 2010-2019 was launched in 2010. Subsequent to that, the HSE established three key clinical programmes for acute coronary syndrome, heart failure and stroke.

Significant improvements have been made with regard to access to acute treatments for coronary heart disease and heart failure as well as the development of stroke units across the country. Heart failure, HF, is one of the major chronic diseases in Ireland today and is one of the commonest reasons, as the Deputy pointed out, for hospital admission in the elderly, often requiring a prolonged stay. It is recognised that integrated management programmes for heart failure, encompassing primary care and hospital services, can produce significant reductions in the need for hospitalisation and achieve better quality of life and outcomes for patients.

The HSE's national clinical programme for heart failure aims to reorganise the way heart failure patients are managed. Recent developments include structured services of acute heart failure. Such services have been established in 11 hospitals as national heart failure units. These sites have introduced a structured specialist hospital service for patients presenting with acute heart failure, including post-discharge follow up. They deliver an integrated service through the model of care developed by the national clinical programme for heart failure, which follows international best practice.

A new diagnostic clinic in the Gorey-Wexford-St.Vincent’s University Hospital Group provides direct access for general practitioners to specialist blood tests and echocardiography in the community with remote specialist advice on echocardiography results and specialist review of patients in the community when required. This improves access for patients to diagnostics and specialist advice. A heart failure integrated care demonstration project in the Carlow-Kilkenny region is planned to commence shortly. It will demonstrate integration between primary care, secondary care and the hospital group. This uses existing e-health technology and will strengthen patient self-care with enhanced nursing supports and training.

Co-ordinated care between primary and secondary care will provide rapid access to specialist opinion and will support identification of heart failure patients in GP practice. It will also provide specialist day care advice to general practice for rapid but non-urgent cases. Appropriate use of specialist advice and avoiding need for hospital and outpatient attendance has been a key target of this programme. Recognising that giving GPs access to senior specialist advice in a structured and timely manner will avert the need for OPD and emergency department referral, led to the development of a consultation service where GPs, practice nurses and specialist staff interact using web conference technology to discuss and manage cases collaboratively. This also allows simultaneous education for the health care professionals as they discuss relevant cases. I will deal with the Deputy's other questions in my supplementary reply.

See this speech in context