Tony McLoughlin (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Ceann Comhairle for selecting this important matter for discussion. I am seeking clarification of the Health Service Executive's plans to deliver a fixed cardiac catheterisation laboratory at Sligo University Hospital in 2017. I have had previous discussions and correspondence with the Minister on this matter, which is of the utmost importance to people in the north west, including those I represent in the constituency of Sligo-Leitrim. A quick glance at a map of Ireland illuminates how people living in the north west are being left behind in terms of access to this life-saving cardiac service. The major question at issue when a person presents at a hospital with an urgent cardiac arrest or other emergency cardiac illness is whether transport to a primary percutaneous coronary intervention, PCI, centre is available within the recommended 90 minutes. For patients in the north west, there is not a simple "Yes" or "No" answer to this question, as is often the case in our region. The answer, unfortunately, varies from day to day and on a case-by-case basis, depending on whether or not the emergency helicopter transport service is available from Sligo at the time. If it is not available or is out on a call, often the only option available is to give the cardia arrest patient thrombolytic treatment followed by an urgent ambulance transfer by road to either Galway or Dublin for emergency treatment.

Having spoken to the senior consultant cardiologist at Sligo University Hospital, Dr. Donal Murray, this is unquestionably having an effect on the levels of cardiac mortality in the region. This tragic reality of the situation must be addressed this year as a matter of urgency. It is estimated that more than 50 patients per year are presenting at Sligo University Hospital in need of urgent attention for an ST-segment elevation myocardial infarction, STEMI, which is the most dangerous type of cardiac arrest. At this time, 50 cardiac patients at Sligo face that uncertainty. A further 150 patients present at the hospital with non-urgent STEMI heart attacks which require treatment outside the region. More than 1,000 patients every year need angiography services which cannot be provided at the hospital.

One of the key challenges in accessing primary PCI care in the north-west region is that the road network is not of the same standard as it is on the east coast or in the south. For example, it takes a minimum of two hours to travel from Sligo University Hospital to Dublin by ambulance. It takes the same length of time to get to Galway by road, but the journey by helicopter is 80 minutes. Therefore, the only option for patients in the region is via air travel to Galway. On that basis, Sligo needs a fixed cardiac catheterisation laboratory with three consultant cardiologists. People living in Sligo, Leitrim, north Roscommon, south Donegal, north Mayo and west Cavan have as much right to access this service as do the people of Galway, Cork, Dublin and Waterford. We have a combined population of more than 240,000 people, who must, as it stands, leave the region for care. Sligo University Hospital is the perfect location for the service given its position between the other primary PCI centres in Galway and Derry. Sligo has a proven track record in innovation, staff recruitment and clinical governance in this field and was the first hospital in the country to establish a mobile catheterisation laboratory service. That is no longer adequate and it is time to upgrade to a fixed service, which will require a minimal capital investment. Doing so would mitigate the impact of the lack of primary PCI care in the region. If the service is not delivered this year, 2,000 patients will have to leave the region for cardiac procedures, which will undoubtedly lead to increased cardiac mortality.

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