Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Minister of State, Deputy Halligan, Deputies Butler, Browne, Cullinane, my colleague from the region, the Minister of State, Deputy John Paul Phelan, and from the other House, Senator Coffey, who have all raised this important issue of cardiology services at UHW. I too was very saddened to hear of the tragic death of a young man, Mr. Power, who was being transferred between two hospitals at the weekend. I offer my sincere condolences to his family. I think it is important that we are sensitive to their needs at this time. As Minister for Health, however, I cannot comment on individual cases and so will address the House on the wider cardiology service issue, except to say that I expect all the proper procedures will take place with regard to the circumstances of this tragic death. I believe that is important.

Last year, in line with a commitment in the Programme for a Partnership Government, an independent review of the need for a second cath lab at UHW was undertaken by Dr. Niall Herity, a world-renowned cardiology expert. The review concluded that the needs of the effective catchment population of UHW could be accommodated from a single cath lab. However, the review also recommended increased investment to enhance cardiology services at the hospital and to provide an additional eight hours cath lab activity per week to address waiting times and provide improved access for patients.

At the time of the publication of the report, I committed to providing those additional resources to the hospital. I did so. The HSE national service plan 2017 subsequently identified the implementation of the recommendations of the Herity report as a priority and additional funding of €500,000 was provided for the hospital. I should also mention, as the Minister of State, Deputy Halligan, alluded to, that the HSE issued a tender this week for a mobile cath lab that will contribute on an interim basis to a further reduction in elective cardiology waiting lists in UHW.

I also committed to a further review to assess the impact that these improvements have had on the volume of patients attending the cath lab and this review will take place at the end of the deployment of the mobile lab. I commit to keeping Oireachtas colleagues from Waterford and the region briefed on plans for that review.

With regard to emergency work at the hospital, I want to stress again that all decisions on how we configure our health services must be evidence-based. I think everybody accepts that and I appreciate that. Dr. Herity recommended that emergency work should cease in order to allow the hospital to focus on the much larger volume of planned work and to contribute to improved patient outcomes. That was the finding of the independent review. I believe it is fair to say that the organisation of primary PCI services is an issue for the whole country. It relates to how we provide services to our whole population taking account of the best evidence available. While we are discussing Waterford and the south east today, it is indeed an issue beyond just the south east. I would point out that patients in Monaghan are transferred to Dublin for primary PCI and patients in parts of Kerry go to CUH. Highly-specialised services such as primary PCI need to be carried out in a small number of hospitals around the country where the volume of patients supports the provision of a safe service. Low-volume services do not facilitate the ongoing and sustainable achievement of the patient outcomes required. That has been the long-held clinical view.

Based upon this country’s population, we can only operate a limited number of primary PCI centres in order to ensure that services achieve required standards and are sustainable. Clinical staff cannot maintain their skills where volumes are insufficient and staff will not be attracted to work in units that do not facilitate them producing the outcomes expected.

I believe it is time for a full national review of primary PCI services. Therefore, I have now asked my Department to make arrangements for this national review to be undertaken based upon independent clinical expertise and this will obviously include the south east of the country. This review will seek to ensure that as many patients as possible have access on a 24-7 basis to safe and sustainable emergency interventions following a heart attack. The review will therefore address the wider implications for all services and all parts of the country of Dr. Herity’s view regarding primary PCI services and will come up with a plan for the achievement of the best patient outcomes possible. Clinical safety is paramount as part of that review.

I want to repeat that extra investment is being provided to allow additional activity at the existing cath lab. The mobile cath lab is confirmed for Waterford and is on the way. There will be a further review of UHW's situation following the deployment of this mobile Iab. I will consult with Waterford Oireachtas Members at that stage with regard to that review. In addition to that, there will be a national review recognising the importance of access to PPCI services for all our citizens.

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