David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I know that the Minister for Health has said he cannot be here, which is unfortunate, given the issue raised. The Minister of State, Deputy Helen McEntee, will know that this is a very important issue for the people of the south east. There was big disappointment when the Herrity report was published and the favourable recommendation for which people were hoping for did not materialise. Five of the six Oireachtas Members for Waterford have sought a meeting with the Minister for Health and hospital consultants. To date, the Minister has not responded, despite the fact that the request was made two weeks ago. He has acknowledged receipt of the letter, but he has yet not agreed to a meeting and is not here to take the motion, which is unfortunate.

The Minister has said over and over again in his response to the media when questioned on this issue that he will accept the recommendations made in the Herrity report. I am someone who passionately believes health care should only be provided based on clinical and medical need. There are questions the Minister has to answer.

The HSE and the Department both describe UHW as the regional hospital for the south east. They outline the regional services that the hospital provides, the first of which is the cardiology service. They say the service coves not part of the south east, but the entire region.

The Higgins report recommended a reconfiguration of hospital services in the south east and elsewhere. A clear assurance was given in that report to the people of the south east that UHW would continue to be the provider of invasive cardiology services for the population of the entire region. How did a report commissioned to look into expanding services not have in its terms of reference that the hospital was the regional provider of cardiology services? Why did it use as a basis for its findings an effective population of just more than half that of the south east region? This is what is upsetting hospital consultants in Waterford, clinicians, us as Oireachtas Members from across the region and the people who came out onto the streets last week. We need to hear from the Minister for Health whether he believes that UHW is the regional hospital that provides regional cardiology services. If he does, the logic of that is that he cannot accept the conclusions of the Herity report.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I have submitted this Topical Issue matter in a bid to ask the Minister for Health directly to meet with cardio consultants at UHW who dispute the findings of the recent Herity report. The Minister indicated straightaway that he was accepting the findings of the report. However, there is a clear view in Waterford that a second opinion is required and that the Minister should listen to it. Consultant cardiologist Dr. Patrick Owens said that lives were at stake as the method used to determine the catchment for the laboratory was wrong. Dr. Owens went on to say that the issue should be revisited by the Government in consultation with local consultants and Dr. Herity. The consultants believe the review is flawed and they completely reject the findings of the report. The consultants pointed out that the report wrongly based its estimate of the catchment population for cardiac services in the south east on patient flows in the unit to Waterford. It did not take into account the constraints on capacity. They believe its recommendations were invalid because of this. Dr. Rob Landers also criticised the clinical review that suggests another catheterization laboratory is not needed at UHW and said that the south east of the country is uniquely disadvantaged when it comes to cardiac care. This is not parish pump politics.

This issue is overwhelmingly one of clinical safety for the people of Waterford and the south east. The Minister for Health says that he will not deviate from the report's recommendation. When a consultant says that a report the Minister is committed to implementing is flawed and that the Minister's decision could compromise clinical safety and that patients will die, and when the Minister says that he does not have a duty to meet with the consultants in Waterford, do they not at least deserve to be heard? I have already written to the Minister on behalf of the Oireachtas Members of Waterford and on behalf of the consultants. We are still awaiting a reply.

Helen McEntee (Meath East, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister for Health, Deputy Simon Harris is unable to be here today due to a pre-arranged meeting which could not be rescheduled. He sends his apologies.

The Minister received the report on the independent clinical review of the need for provision of a second catheterization laboratory at UHW on foot of the programme for Government commitment. The report was completed by Dr. Niall Herity, a highly-respected Belfast-based cardiologist. It is a comprehensive report which reflects the fact that Dr. Herity consulted widely and met with all of the key stakeholders, including the management and staff of both UHW and Cork University Hospital. Dr. Herity’s calculation of the catchment population for the UHW catheterization laboratory has been challenged since publication of the review.

In his report, Dr. Herity rightly points out that it would be a mistake to assume that the catchment area of UHW is represented by every resident in Waterford and its surrounding counties. Dr. Herity therefore determined the effective catchment population by looking at regional patient flow data and combining this with 2016 census data in regard to the population of Waterford and surrounding counties. Dr. Herity has provided robust evidence that a second cardiac catheterization laboratory at UHW is not justified. However, he recommends increasing the number of weekly sessions currently provided, along with the requisite additional staffing for the increase in sessions, in order to address waiting times and to provide improved access. He also recommends that new specialist equipment be provided to improve contingency for radiological equipment failure during a procedure. The Minister is happy to provide the additional resources necessary to implement these recommendations and as such significantly improve services for patients at UHW. This investment will be reflected in the HSE national service plan for 2017.

During this period of investment and enhancement of services, the situation will be closely monitored. A further independent clinical review will be carried out in early 2017 to assess the impact that these improvements have had on the volume of patients attending the catheterization laboratory in UHW. Dr. Herity has recommended that the UHW catheterization laboratory should operate as an elective laboratory which provides all specialised cardiac services except interventional treatment for patients who are having heart attacks. Dr. Herity has also recommended that the current 9 to 5 provision of these services should cease to allow the hospital to focus on the much larger volume of planned catheterization laboratory work.

The Minister has to be certain that any change to how a service is delivered will result in improved services for the patients using it. Therefore he has asked the Department to address the implications of this recommendation by undertaking a national review of all primary percutaneous coronary intervention, PCI, services with the aim of ensuring that as many patients as possible have access on a 24/7 basis to safe and sustainable emergency interventions following a heart attack. It is expected this review will be completed by the end of July 2017.

The Minister intends to visit UHW in the coming weeks and will take the opportunity to speak with staff and management on a broad range of issues.

David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

The response of the Minister of State is extraordinary. I know it is coming from the Minister for Health himself. The response says that Dr. Herity rightly points out that it would be a mistake to assume that the catchment area of UHW is represented by every resident in Waterford and its surrounding counties and goes on to say that he therefore determined the effective catchment population by looking at regional patient flow data. How does that sit with official HSE and Department policy that UHW is the regional hospital for the south east? Has policy changed? Is the Minister for Health now saying that UHW is no longer a regional hospital and is some sort of glorified general hospital? If one logs on to the HSE website or Googles UHW one will find that UHW is a regional hospital providing regional services, including cardiology. Was Dr. Higgins lied to when a commitment was given that the Government would continue to provide invasive cardiology services to the people of the south east? Were the people of the south east lied to? Were hospital consultants lied to? That is how it seems to me when I read this response that says he was right to "assume". Why should he assume? It is either policy or it is not. He has no right to assume. Nobody has a right to assume. It should have been based on medical, clinical need and existing policy. In my view, the existing policy is that UHW is a regional hospital. The Minister needs to explain to the people of the south east whether that policy has changed.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

In Waterford city last Saturday, in excess of 2,000 people marched in miserable weather of wind and rain to voice their anger and dismay at the lack of 24/7 cardiology cover in Waterford. The Minister for Health, Deputy Harris, has consistently stated that he was accepting the Herity report because it was an independent clinical report. I need the Minister to answer the following question. A note was prepared by the HSE's acute hospital policy unit 3. This note was given to Dr. Herity and it referred to the growing public and political pressure in the Waterford region to build and staff an additional catheterization laboratory at the hospital and to expand the existing services to 24/7. The note states: "However, it has been the view of the Department that providing additional facilities and extending PPCI (angioplasty) services, in a geographical area which does not have the population base to justify such a service, would be wasteful of very limited resources". The Minister tells us that this was an independent clinical review. In my opinion, this is gross interference by the HSE.

Helen McEntee (Meath East, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I reiterate that the Minister for Health, Deputy Harris, has to be certain that any changes to service will deliver the results that will improve services for the patients using them. The fact that the Minister has indicated that he intends to visit UHW in the coming weeks and meet with these organisations will give the Deputies an opportunity to raise many of the questions they have asked here and go into them in more detail.