Mary Butler (Waterford, Fianna Fail)
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As the Minister is well aware, the issue of 24/7 cardiac care and the provision of a second cath lab at University Hospital Waterford is one that has been raised on numerous occasions in this the Thirty-second Dáil by me and my colleagues, both cross-party and those of none. Notwithstanding the numerous representations on this issue, the current situation in University Hospital Waterford remains the same. Cardiac services in the hospital are time sensitive, opening Monday to Friday, 9 a.m. to 5 p.m., and being closed all day Saturday and Sunday. It is simply not acceptable that time restrictions play such a role in the day to day lives of the people of the south east. If a patient presents as requiring cardiac intervention services outside these times, the only option is an ambulance to Cork University Hospital or St. James's Hospital in Dublin. Recently, the death of Mr. Thomas Power brought into sharp focus the absolute single point of failure of the current service, the difficulty with the road network to Cork University Hospital and arriving there within the required 90 minutes and the capacity demand mismatch of the current opening hours.

On Tuesday of this week, after a frantic few days working with Deputy Cullinane to ensure the wording was correct, a motion was tabled in the Dáil. It was signed by all the Deputies of Fianna Fáil, Sinn Féin, the Labour Party, the Green Party and the Rural Alliance as well as Deputies Mick Wallace and Clare Daly. I thank each and every one of those who supported the motion. It has shown that we can work together. We may have different political ideologies, but this has to transcend politics because people's lives are at stake. As I said, the Power family recently lost a son, a brother, a husband and a soon-to-be dad.

The motion calls on the Government to immediately initiate a second independent review into the provision of cardiac care in the south east. The motion also calls on the Minister to commence its work within six weeks of the passing of the motion. Due to Dáil time restrictions and regulations this week, it was not possible to hear the motion. The motion was forwarded to the Minister and a meeting requested. As a result, we met the Minister, Deputy Harris, and officials from the Department of Health this evening at 6 p.m. All Waterford Oireachtas Members were invited to attend and those present were the Minister of State, Deputy Halligan, Deputy Cullinane, Senator Coffey and me. Senator Grace O'Sullivan was represented at the meeting.

This cross-party meeting was very constructive. This was not about politics. Rather, we were all working together, sitting around a table, trying to find a way forward, a clear pathway, a sign-post as to how we could move on the issue.

This was a frank, open meeting and all those present outlined the pressing need for the review to commence as speedily as possible. We impressed on the Minister the need for urgent and speedy action. We pointed out what we consider to be the failings with the current system, the depth of feelings in Waterford and the south east and the absolute necessity for immediate movement. We all detected a step change with the Minister and his officials and a greater understanding of the issues being experienced in the south east. We all understand that this service can only be delivered based on clear medical and clinical need and, unfortunately, the Herity report did not show this to be the case.

I welcome the Minister's decision tonight to expedite a national review of all primary PCI services, encompassing the south-east region. I look forward to the statement he will make to the House.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Butler for tabling this important Topical Issue. Her summation of our meeting this evening is accurate and I agree with it. First, I once more extend my sincere sympathy to the family of Mr. Power and to his community on his tragic loss. As I said previously, I expect that all appropriate procedures will be carried out to ensure the facts and information that are extraordinarily important in this case, including to the Power family, are made known to the family.

I welcome the opportunity to update the House on the provision of cardiac care in the south east. I thank Deputies Butler and Cullinane, Senator Coffey, the Minister of State at the Department of Education and Skills, Deputy Halligan, and Deputy Catherine Martin, on behalf of Senator Grace O'Sullivan, for attending our earlier meeting which I believe was very constructive. I note the apologies of Deputy Deasy, whom I have briefed on it. I also acknowledge the interest of Members of the Oireachtas from the south east in general, including the Minister of State at the Department of Housing, Planning, Community and Local Government, Deputy John Paul Phelan. I have significant respect and admiration for the way Members of the Oireachtas in Waterford and the south east are working on a cross-party basis and in a constructive manner to try to find a way forward.

On foot of the meeting and in light of the cross-party motion, I am pleased to confirm that I have agreed to expedite a national review of all primary PCI services, encompassing the south-east region. I issued a statement to that effect this evening. My Department will immediately commence the preparatory work on examining the scope of the review, including identifying an international expert. It is important to have an international expert. The guiding principles for this review will be to strive to provide a primary PCI service that can deliver clinical outcomes on a par with international standards, something to which we all subscribe. I wish to be clear this does not affect the additional resources I have already committed to provide to University Hospital Waterford, the commitment to review the impact of extended hours at the existing catheterisation laboratory, and the deployment of a mobile catheterisation laboratory, which will arrive in Waterford in the autumn.

As I have previously confirmed, the HSE national service plan for 2017 provided additional funding of €500,000 and, as part of that expenditure, the HSE is currently in the process of procuring a temporary mobile catheterisation laboratory at University Hospital Waterford which will contribute, on an interim basis, to the further reduction in elective cardiology waiting lists at that hospital. The organisation of primary PCI services is an issue for the entire country, as we discussed at our meeting. I accept it is an extraordinarily emotive and important issue in the south east, but there are also other parts of the country that have concerns and views about this. It must relate to how we provide services to the entire population taking account of the best independent clinical evidence available. The review will encompass all areas of the country, including the south east, and 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.

My Department will begin the preparatory work, which will include identifying an international expert and scoping the terms of reference. I intend to engage further with Members of the Oireachtas from Waterford and the south east in the coming weeks and certainly by early September to plan a way forward to ensure there is a robust process that will examine all parts of the country and the distribution of our primary PCI services. Ultimately, every Member of the Oireachtas and all parties wish to arrive at a point where the maximum number of citizens have access to 24-7 primary PCI services. Again, I thank the Deputies and Senators from Waterford and the south east for the constructive manner in which they have engaged this week. It has been useful and helpful and I hope we can progress along the lines I have outlined.

Mary Butler (Waterford, Fianna Fail)
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I welcome the Minister's statement. I also welcome the fact that following today's meeting we have moved much quicker to what we hoped to achieve by pressing the motion in September after the recess. The Minister stated that the 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 encompass all regions of the country, including the south east.

The Minister said his Department will immediately commence the preparatory work, including identifying an international expert and examining the scope of the review. Time is of the essence so it is essential that the preparatory work commences immediately and that no day is wasted. The terms of reference will be extremely important and I welcome that an international expert will undertake the review. The guiding principle for the review will be to strive to provide a primary PCI service that can deliver clinical outcomes on a par with international standards. This service can only be delivered on clinical and medical outcomes and the consultants in Waterford and the south east recognise that fact.

I also welcome that the review does not impact the additional resources provided to University Hospital Waterford, the extension of the eight hours opening time, for which staff are currently being recruited, and the commitment to the deployment of a mobile catheterisation laboratory which will deal with 460 people who are currently waiting for services. I also wish to refer to the Minister's previous commitment to a stand-alone regional review. We understand that this might be superseded in the event of a favourable recommendation following the national review.

This is a stepping stone. We have a long way to go. I respect what the Minister has achieved tonight and I look forward to engaging again with him and the other Members of the Oireachtas from the south east and Waterford. It is imperative that we work together. The outcome must deliver 24-7 cardiac care for the people of Waterford and the south east. Our voices will continue to be heard as we work together in a constructive manner.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Butler for her fair and constructive remarks. I also thank her and all the Members of the Oireachtas from Waterford for not playing politics with an issue that we all agree is far more important than party politics. It is about showing that people can work together, regardless of party affiliation, to try to move forward in a constructive way. Deputy Butler spoke about the importance of clinical and medical evidence. That is important because we can only design a health service on that basis, not political decision making. For that reason, all parties in the House subscribing to the idea of a national review with an independent international expert and clear terms of reference is very important. It is important to have an international expert as that will add significantly to the national review.

To be absolutely clear, the additional resources which I have already announced for University Hospital Waterford will remain in place. There is a benefit to that in the immediate term through additional opening hours, extra staff, more procedures being carried out and the mobile catheterisation laboratory ensuring that elective procedure waiting times in the south east can be driven down further. We have made some progress on that in recent months and more will be made with the mobile catheterisation laboratory. I will continue to engage with my colleagues from the south east as we move towards the establishment of this national review, which hopefully will benefit all our citizens in all the regions as we try to plan the best possible primary PCI services to deliver standards that we can all be proud of and that are internationally benchmarked.