Mick Wallace (Wexford, Independent) | Oireachtas source

It is an issue that is a real worry for the people where I come from in the south of Wexford because we are in the absolute worst position of all when it comes to the problems around this issue. A few months ago, I submitted a number of questions to the Department of Health on ambulance response times between various hospitals in the south east and St. James's Hospital in Dublin and Cork University Hospital. The questions were devised by a 24-7 cardiac care campaigner, Matt Shanahan, who has done tremendous and intelligent work over the past number of years to highlight the madness of a lack of 24-7 emergency cardiac care in the south east. His aim was to try to establish how many patients in the south east are getting to a cath lab within the 90-minute window recommended in the Herity report. The 2016 Herity report states that the average blue light ambulance journey time between Waterford hospital and Cork is one hour and 20 minutes. The HSE's answers to my parliamentary questions have demolished this claim and made a nonsense of the report.

I appreciate the Department needs to make evidence-based decisions in the provision of health services but how can the Department continue to stand over the Herity report, especially considering its problems in terms of population calculations and the lack of consultation with consultant cardiologists at Wexford General Hospital? The data show that not one of the 37 emergency cardiac transfers from Wexford over the past three years was completed within 90 minutes. In the same three-year period, from the time the ambulance was called, just two patients made it from University Hospital Waterford to Cork in under 90 minutes. The dogs in the street in the south east know this. It is common sense. The Department, the HSE and Dr. Herity all have access to the national ambulance service response times. They must have been aware of the reality of these transfer times. Did the Department look at them and was it aware of the reality of the transfer times?

The Herity report estimates that approximately 175,000 people in the south east are outside the 90-minute window accessing Cork hospital and St. James's. In the real world, the data I received via my parliamentary questions suggest that the population outside the 90-minute window is closer to 0.5 million people, which is almost the whole south-east region. The Herity report uses a 90-minute journey time as its acute coronary syndrome, ACS, standard. This ACS standard does not exist anywhere else. The equivalent standard in the UK is based on 90 minutes from first responder time to balloon time, or when the patient is on the operating table. Elsewhere in the EU, they aspire to a 60-minute transfer time. Meanwhile for people in south Wexford and the south east, the data I received show transfers of closer to two hours. Consultant cardiologist at University Hospital Waterford, Dr. Patrick Owens, told "Prime Time" that people have without doubt died en routeto Dublin or Cork because they have been unable to access the service in a prompt and timely manner. Does the Minister of State accept that statement as true? Dr. Herity told the Oireachtas committee that 150 STEMI cases per year in the south east was needed to justify 24-7 cardiac care in the region. I have been told that approximately 200 STEMI cases were treated in Waterford hospital in 2017. Professor Daly, who did the 2018 ACS report, gave a figure of 203 STEMI cases to cardiologists at Waterford Hospital as a predicted outcome figure for 2017. The Herity report does not stack up. If one takes on board the extra time, Dr. Herity did not look at the time it takes to get to the patient. He was only counting from the time the ambulance picked the patient up to the minute the patient got on the operating table. We cannot ignore the fact that in Wexford on average it took an ambulance 53 minutes from request and departing Wexford hospital to St. James's or to Cork.

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