Mary Butler (Waterford, Fianna Fail)
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The provision of 24-7 cardiac care at University Hospital Waterford and the south east has long been debated in this House and the Minister of State, Deputy Finian McGrath, is well aware of the situation. I thank him for taking this Topical Issue. I am disappointed the Minister for Health cannot be here. There was an announcement yesterday about the delivery of a modular lab to be located at University Hospital Waterford that would perform both diagnostic and intervention procedures. The funding for this modular lab is to be included in the 2019 Estimate.

The Minister informed Members of the Oireachtas that he believes there is merit in the proposal for a modular cardiac catheterisation lab at University Hospital Waterford in order to address waiting times at the hospital and provide a better service for the people of Waterford and the south east. This is welcome. As the Minister of State is well aware, all Members from Waterford and the south east have combined and worked together on this issue but I must advise today that there is still a capacity demand issue and a very limited service of 40 hours per week in the existing lab with no service at the weekends. The Minister stated that he had received advice from the HSE and that some further work is required on the detail relating to tendering, project design work, planning, construction and commissioning. I am asking for that further detail. We need a clear timeframe and an expected delivery date.

The consultants at the hospital feel that this modular unit will greatly enhance the cardiac services they offer to the public. Having one elective and non-elective lab is now possible but it needs to be delivered as a matter of priority without any delay. I would really appreciate it if the Minister of State could give us information as to when we can expect to see this modular lab on the ground so that we can save lives.

David Cullinane (Waterford, Sinn Fein)
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Last year, all Members from the south east came together to lobby the Minister on this issue as best they could. The Minister of State knows this has been longstanding issue not just in Waterford but in the south east. Unfortunately, the south east is the only primary percutaneous coronary intervention, PCI, centre, of which there are six in the State, that provides a limited nine-to-five, Monday-to-Friday service. Every other centre provides a 24-hour emergency cardiac service. While we are here today rightly welcoming the announcement that a modular lab will be provided at University Hospital Waterford for a specified period of time, the ultimate goal is to ensure the south east is on a level playing field and has the same level of service as other regions.

The announcement yesterday by the Minister of State, Deputy Halligan, which was reaffirmed in a letter by the Minister for Health, is that the Minister is committed to the deployment of a modular lab and that the money will be made available in the budget in October. However, a lengthy process must be gone through. I accept that there is a process, things cannot be done overnight and there are issues relating to procurement and planning issues and all of those considerations need to be dealt with. However, as Deputy Butler said, what we need is a clear timetable because there is a fear that the issue will be kicked down the road, as has happened in the past, and that the Minister, Department or somebody else will drag their feet. We need to be able to hold the Government and Minister to account. I commend the Minister for making the announcement yesterday and I commend all the Members who worked collaboratively and very hard to get this over the line but we need to know what exactly is involved in terms of procurement, planning, construction and design plans. What is the timeframe from now until delivery date? While the money may be committed in the budget, there is no reason why the planning side of it cannot happen now. It should happen today or tomorrow and not after the budget when the money is ring fenced.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputies Butler and Cullinane for raising the important issue of cardiac services at University Hospital Waterford and for giving me an opportunity to update the House on the latest position in this regard on behalf of the Minister and to convey the total support of the Minister of State, Deputy Halligan, on this issue. As they are aware, the Government has taken a number of actions on this important issue starting with approving increased funding to allow for the recruitment of staff to support increased hours at the existing lab. While recruitment has been slow, in the interim, a mobile catheterisation lab has been deployed at University Hospital Waterford and this has led to a decrease in the length of time that people are waiting for diagnostic procedures.

The Deputies will be aware that when the Minister met with Members from the south east on 14 February last, he indicated that he would give consideration to the various issues raised by the group, including the potential for the deployment of a modular catheterisation lab. As I believe he advised in a letter to the Members yesterday, he has now conveyed his view that there is merit in the proposal in order to address waiting times at the hospital further and provide a better service for the people of Waterford and the south east. That is something we all strongly support. He has received advice from the HSE on the proposal and while there is some further work required on the detail, he has asked the Department to proceed without delay to engage with the HSE on the next steps in providing a modular lab. I understand the timeframe for the development of modular builds as outlined by the HSE must include tendering, project design work, planning, construction and commissioning so it will take until next year to deliver. However, I think it is very important that the Minister has committed that this will be funded in the 2019 Estimate and that work should begin immediately on the process to deliver it.

In the interim, the mobile catheterisation lab continues to be deployed. The national review of specialist cardiac services is well underway and issued a report on its sixth meeting yesterday. The aim of this review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service. As set out in the national development plan 2018-27, investment in cardiac catheterisation laboratories and other cardiac services infrastructure nationally will be informed by the outcome of the national review, which is expected to be complete by June 2019.

I know the Minister will continue to work with the Deputies and their south-east colleagues towards achieving better outcomes for all patients in the region.

Mary Butler (Waterford, Fianna Fail)
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This is certainly a step in the right direction towards the ultimate goal of 24-7 cardiac care in the south-east. I cannot emphasise enough the importance of delivery as soon as possible. It is 6.30 p.m. and here in Dublin, if any of us were to have a cardiac issue, we could be brought to one of many cath labs throughout Dublin. However, in Waterford and the south-east the cath lab has been closed since 5 p.m. and it will not open again until 9 a.m. in the morning. The Minister of State has to understand how important this issue is to us. The lab opens from 9 a.m. to 5 p.m., Monday to Friday, with absolutely no cover at the weekend. A patient has only the option of being transferred in an ambulance to Cork.

I have always maintained we need a 24-7 cath lab at University Hospital Waterford which can provide both diagnostic and cardiac intervention. Waiting lists at University Hospital Waterford for cardiac diagnostic procedures are currently at an all-time high. The only way to deal with this is to get the modular lab on the ground as soon as possible. We will have to continue to hold the Minister to account until we see it.

David Cullinane (Waterford, Sinn Fein)
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I have already said this is a step forward for people in Waterford and the south-east. As somebody who lobbied the Minister to put this in place as an interim, temporary measure until the national review completes its work, and we are hoping for a favourable outcome, I am somewhat disappointed with the language in the speech the Minister of State read out. It states there is merit in the proposal but further work is required, and it then states it will take until next year to deliver. Is that next January, March, June or December? It talks about the different issues and hurdles which will have to be overcome, such as tendering, project design work, planning, construction and commissioning. We need something a bit more concrete.

I ask the Minister of State to go back to the Minister for Health and ask him to meet the Oireachtas Members before the Dáil recess, as he promised, to outline to us actual timeframes. In any capital project, one has targets in terms of whether it is the first quarter, second quarter or third quarter of the year, and there are timeframes around all the different stages in the process. We have no timeframe here. The Minister of State will accept we need a bit more than what is in his response in order to give comfort to the people of the south-east that this will be delivered as quickly as possible.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputies Cullinane and Butler for the points raised. I agree 100% that the people of Waterford deserve a better service. I have been asked by the Minister of State, Deputy John Halligan, to commend and thank the Deputies for their support and for working together to improve services for the people of Waterford. The Minister of State specifically asked me to say this.

David Cullinane (Waterford, Sinn Fein)
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He will be happy to get a mention.

Finian McGrath (Dublin Bay North, Independent)
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With regard to the points about the timeframe and the delivery date, I will go back to the Minister on that issue. Of course, there will be issues in regard to procurement and planning, as well as the potential for delays. I have experienced this in regard to the new accident and emergency unit at Beaumont Hospital so I know exactly where the Deputies are coming from. I reassure them there will be no kicking the can down the road on this issue. The Independent Alliance and the Government are very supportive of the people of Waterford. The Minister of State, Deputy Halligan, has been pushing this issue in government with the Minister and we have been supporting him. Likewise, we are very supportive of the needs of the people of Waterford because we feel very strongly that they have been left out of the picture and they are entitled to the same level of service as other regions of the country. There is no debate on that issue.

The Herity report concluded that the needs of the effective catchment population for University Hospital Waterford could be accommodated from a single cath lab. Funding has been provided to support extension of the existing cath lab operating hours to 12 sessions per week, or by 20%, as recommended by the Herity report. The HSE has advised that the posts will be required to facilitate the service extension to the existing cath lab were originally envisaged to be reduced whole-time equivalent posts, that is, all posts were 0.25 whole-time equivalent with the exception of the nursing posts, which were 0.75 whole-time equivalent. While it has proved difficult to recruit suitably qualified staff for the 0.25 whole-time equivalent posts, these posts have now been designated as full-time equivalents. Recruitment is currently being progressed by the national recruitment service and it is hoped that, as full-time posts, the recruitment will be successful.

All the issues the Deputies have raised will be brought back to the Minister and we guarantee them our maximum support.