David Stanton (Cork East, Fine Gael) | Oireachtas source

I thank the Ceann Comhairle for selecting this issue. I also thank the Minister, Deputy Varadkar, for coming to the House to deal with the need for a specialist heart failure unit in Cork, an issue I have raised a number of times in recent weeks.

Last Tuesday, 15 December, I attended the launch of the report entitled, The Cost of Heart Failure in Ireland, which was produced under the auspices of the Irish Heart Foundation and presented by Mr. Brendan Kennelly of NUIG, who is a health economist. It makes for graphic reading. According to that report, the cost to Irish society of heart failure is €660 million per annum, which is a concern. The report also states that heart failure can be addressed at community level. The direct cost of heart failure to the HSE is €158 million. Some 90,000 people are affected and a further 160,000 have impending heart failure. Heart failure hospital admissions accounted for 8% of HSE inpatient bed days in 2012. The total annual bed days taken up for heart failure is more than 230,000 and the average length of stay is 11 days. The condition accounted for more than 40% of all cardiovascular disease bed days and 35% of inpatient stays during 2012. One in five people over the age of 40 will develop heart failure in their lifetime and it is set to become an epidemic due to an ageing population.

The report also estimates that nearly 4,500 patients are admitted to public hospitals with heart failure as their primary diagnosis each year,while heart failure accounts for 30% of all readmissions related to cardiovascular disease. Dr. Angie Brown of Irish Heart Foundationsaid at the launch that during 2012, 537 people had died as a result of heart failure. It is a huge health concern in Ireland and, worryingly, only 7% of people can identify the common signs of heart failure, with people often mistaking them for the signs of ageing.

There are currently 12 heart failure units operating across the country, six of which are located in Dublin at St. Vincent's hospital, Tallaght hospital, St. James's Hospital, the Mater hospital, Beaumont Hospital and Connolly hospital. There is also one heart failure unit in Drogheda, Wexford, Galway, Cavan, Sligo and Limerick. There is no heart failure unit in the south, which is the reason I have raised this issue today. Cork University Hospital provides a tertiary referral service for cardiology and cardiothoracic surgery to the southern region. I am told that there were to be two heart failure units in Cork, one in CUH and the other in the Mercy hospital but that this was put on hold in 2010-2011 to focus on the development of a unit in CUH. A limited heart failure clinic was established in Cork University Hospital in April 2008 from within existing resources. However, this service is verylimited in scopebecause of a lack of dedicated resources. It operates from the rapid access chest pain clinic, RACPC, located at level 3C, cardiac renal centre, CUH. Between ten and 15 follow up heart failure patients are reviewed per week. There is no dedicated inpatient heart failure service and no new heart failure patient referrals have been accepted to the clinic since August 2011.

Due to nursing and wider resource challenges and the negative impact the heart failure clinic was having on chest pain clinic activity and patient wait times, a dedicated heart failure service was a key priority of the HSE national acute medicine programme and the CUH service plan in 2011.I was advised by the HSE that the recruitment embargo prevented its implementation in CUH.How is it that opening of the units in other parts of the country were not affected by the recruitment embargo? As I said, there is no heart failure unit across the southern region. Will funding for various positions be made available or has such funding already been made available but was not spent? It would be a serious matter if that was the case. I would like an answer to that question. I understand that submissions on a heart failure unit have been made in respect of the 2016 service plan and that resources for a unit in CUH is the number one priority in this submission.

I was advised by the Minister recently that he is not in a position to commit funding. I reiterate that this is a very serious matter. The service could save money because many of these issues can be dealt with in the community. I look forward to the Minister's response and hope it is positive.

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