Jimmy Deenihan (Kerry North, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this matter. Cardiovascular disease is the leading cause of death in Ireland. County Kerry has the highest incidence of cardiovascular disease in Ireland. Documentation provided by the CHAIR project organised by the former Southern Health Board clearly demonstrated that cardiovascular patients in County Kerry are under-served compared to patients in Cork.

A cardiologist was appointed six months ago to provide a cardiology service for Kerry patients both in Tralee General Hospital and in the private hospital, the Bon Secours Hospital, Tralee. This improved access considerably for Kerry patients to invasive cardiology facilities, in other words, angiograms. Prior to the appointment 4% of CHAIR admissions to Tralee General Hospital had coronary-angiography as inpatients. After his appointment such admissions increased to 17%. The service for public patients was withdrawn recently due to a lack of funding. This is disappointing as the service provided by the consultant, Dr. Victor Kocka, was proven to be extremely effective and beneficial.

The national cardiovascular strategy report of 2003 recommended a full-time cardiologist for County Kerry as a matter of priority at that time. We still did not get that cardiologist. Currently there is 0.4% of a cardiology post in County Kerry serving a population of 126,000. County Cork which has a population of 420,000 has six cardiologists. I understand Comhairle na nOspidéal is evaluating the case for the appointment of a full-time cardiologist in Kerry.

I appeal to the Minister of State to convey to the Minister my request that a full-time cardiologist be appointed to Tralee General Hospital starting in January 2006. This appointment should also be accompanied by the necessary support staff and adequate funding. Serious consideration should also be given to the provision of invasive cardiology facilities, including coronary angiography, coronary intervention and permanent pacingin Tralee General Hospital. These facilities would be most beneficial for Kerry patients and would provide urgent access and avoid the long journey patients have to endure to avail of this facility in Cork city. I appeal to the Minister of State to represent my case to the Minister as a matter of urgency. For whatever reason Kerry has the highest rate of coronary disease in the country. For example, in the period from 1998 to 2002 of the 25,149 deaths in the Southern Health Board region, counties Kerry and Cork, 10,726, or 43%, were attributed to diseases of the circulatory system and the higher percentage of those was in County Kerry. It makes no sense that County Kerry would be without a single cardiologist. It is unfair to the population of Kerry. Without wishing to exaggerate, I am convinced that fatalities have occurred in the past and will do so in future because of the lack of basic cardiovascular treatment facilities in the county. This is an urgent matter and I thank you, a Cheann Comhairle, for having allowed me to raise it on the Adjournment.

Tony Killeen (Clare, Fianna Fail)
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I have been asked to take this Adjournment matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

I thank Deputy Deenihan for having raised this matter as it provides me with an opportunity to outline the details of the work in progress to address cardiovascular disease in Kerry. The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the provision of services at Kerry General Hospital.

Heart disease is the single biggest killer in Ireland and living with heart disease is an everyday reality for thousands of Irish people and their families. To tackle this disease the Government launched, in 1999, the cardiovascular health strategy "Building Healthier Hearts", which contains 211 evidence-based recommendations.

The overall aims of the strategy are: to reduce the risk factor profile in the general population, to detect those at high risk, to deal effectively with those who have clinical diseases, and to ensure the best survival and quality of life outcome for those recovering from an acute attack.

Since 1999, the Government has committed more than €60 million towards the implementation of the strategy. This funding has supported a wide range of new regional services and initiatives, which have had a measurable impact on the diagnosis and treatment of patients with heart disease.

As regards tackling cardiovascular disease, the Department of Health and Children has been advised by the Health Service Executive's southern area that investment in the development of cardiology services has taken place in all service areas across the region in Cork and Kerry under the cardiovascular health strategy. Cardiovascular disease accounts for 46% of all deaths in Cork and Kerry.

In line with priorities identified in the Southern Health Board's cardiovascular health strategy five-year action plan, published in June 2000, Kerry General Hospital received in excess of €500,000 over the first three years of the strategy to develop cardiology-related services in the hospital. This has resulted in the appointment of 11.5 technical and administrative staff for the hospital.

The strengthening of its infrastructure has enabled Kerry General Hospital to develop a cardiac rehabilitation service and a cardiac non-invasive diagnostic service, as well as extending its telemetry service in cardiac care units, extending its resuscitation-training programme and providing for ongoing staff training. It has also ensured that essential cardiac equipment was procured for the cardiology services at the hospital.

I am advised that the priority for the region, as identified in the interim report of the joint working group on cardiology manpower is the appointment of a full-time consultant cardiologist at Kerry General Hospital.

In April 2004, €350,000 was allocated under the strategy to support the consultant post in Kerry cardiac rehabilitation services and a first responder programme in the region. Subsequently, €160,000 was allocated in 2004 to begin the process of establishing the consultant cardiology service in Kerry with a full year allocation of €476,000 in 2005. This funding has allowed the HSE southern area to appoint a cardiac technician, nurse and clerical support, as well as providing non-pay costs for such services as angiograms and angioplasts.

A consultant cardiologist was appointed in 2005 in a partnership arrangement between Kerry General Hospital and the Bon Secours Hospital, Tralee. The principal appointment is with the Bon Secours Hospital in Tralee and involves a temporary sessional arrangement with Kerry General Hospital enabling the consultant to work in partnership with Kerry General Hospital in developing specialist cardiology services. Weekly sessions are divided on the following basis: Bon Secours Hospital, Tralee, seven sessions and Kerry General Hospital, four sessions.

I am advised that an application has been forwarded to NHO/Comhairle to seek funding for a full-time consultant cardiologist post for Kerry General Hospital. I am confident that Kerry General Hospital will continue to provide high quality services to the people of Kerry.