Marian Harkin (Sligo-Leitrim, Independent)
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Last week, the Saolta University Health Care Group announced the closure of the two day per week cath lab service at Sligo University Hospital, SUH. This announcement sent shockwaves not just through the community in Sligo, but across Leitrim, Roscommon, Donegal, Mayo and Cavan. This two day per week service was inadequate to begin with. What we really need is a full-time service. It is a slap in the face that this service is being withdrawn. What steps were taken by the Minister or the HSE to stop this service closing at the end of June? I sat in this Chamber just a few weeks ago and listened to the Taoiseach tell a Deputy that the second cath lab in Waterford is being funded and that staff resources are in place. Good luck to the people of Waterford and the south east. They need that lab but what about the north west? Why are we being bypassed again? North of a line from Dublin to Galway, there are no specialist centres. There are two in Dublin and one each in Waterford, Cork, Limerick and Galway. According to the national heart attack audit report, it is estimated that it takes heart attack patients approximately three hours to reach Galway from their time of arrival in Sligo University Hospital. That is the median time. The ideal time is 90 minutes. What government could stand over this discrimination? Will the Minister of State explain to us this evening why this is happening?

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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Deputy Harkin and I, and in fairness all of the other Deputies in our constituency, have been talking about cath lab services for Sligo since I was elected to the House in 2016. It was a one to two day a week service in a mobile unit. It was totally inadequate and not doing the job. I remember speaking to the cardiologist in the hospital, Dr. Murray, and he told me that when he retires, it will be very difficult to get another cardiologist because nobody will want to work in a hospital that does not have the diagnostic services. Despite this, we are now not only talking about the poor and inadequate service we had but about that service being taken away entirely. It is an absolute disgrace that this is happening. Deputy Harkin spoke about a line between Dublin and Galway. There is nothing above that line. What are the people of the north west supposed to do? Where are the answers here? It is just unbelievable.

Last December, I submitted a written question on this matter and was told that a national review of specialist cardiac services under the chairmanship of Professor Philip Nolan was continuing. That started in 2018. We are now in 2022 and the inadequate service we have is being taken away. Prior to that, in 2013, the HSE in the north west carried out a review of cardiac services and indicated that there should be a full, proper, permanent service put in place in Sligo University Hospital. Here we are, almost ten years later, and the inadequate service that was there, which was useless for anyone who happened to suffer a cardiac arrest or other problem on the wrong day of the week, is now being taken away. It is beyond belief that this is happening. I have not read the Minister of State's response yet but the serious problem we had until now has become a serious crisis. The Government has to have a long-term solution to this, which is to put a full and proper service in place, but it must also immediately ensure that the poor and inadequate service we have now is at least kept in place until a full and proper service is provided.

Mary Butler (Waterford, Fianna Fail)
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I thank both Deputies for raising this really serious issue. I am here with my colleague from Waterford who is Acting Chairman tonight. We could talk about cath labs all day long. My very first speech after being elected in 2016 related to cath lab services in Waterford.

As the Deputies will know, mobile cardiac cath lab services have been provided at Sligo University Hospital by a private company. I am informed by the HSE that the company concerned is to cease its provision of mobile cath lab services at SUH and other hospitals in the Irish market at the end of June. As a result, the Saolta University Hospital Group is working with hospital management on contingency measures to ensure adequate services are provided to patients. The HSE has advised that all options have been explored in relation to the continued provision of cath lab services in SUH after the cessation by the current service provider later this month.

In light of these considerations and the lack of private service providers in the marketplace, it is not possible for the service to continue in SUH when the mobile service ends on 30 June. As a result, the service will temporarily be provided at University Hospital Galway, UHG. Strong clinical service links are in place between Sligo and Galway, with an existing cardiologist at SUH providing a sessional commitment at UHG. Designated access will be provided for Sligo patients at the UHG cath lab unit.

We are also waiting patiently on the national review of specialist cardiac services, which is in its final stages and due to be published shortly. The review will set out the roadmap for future delivery of cardiac services nationally. As Deputy Martin Kenny said, the national review of specialist cardiac services commenced in January 2018 under the chairmanship of Professor Philip Nolan and a steering group formed from nominations of interested stakeholders representing medical, professional and technical staff and nursing and patient representatives. The aim of the cardiac services 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. This aligns with the Sláintecare reform programme. In terms of scope, the national review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults.

I know the Deputies will be extremely disappointed with the answer I have read out.

We have all come together in Waterford and the south east for many years trying to achieve an extension of hours in cardiac services. I understand how devastated the Deputies are to lose the limited cardiac service Sligo has because the private provider is leaving. While I cannot say for definite, I am pretty sure it is the same provider that previously provided services in Waterford three days a week. Apparently, it is ceasing to operate in the country completely. It is leaving the Deputies in a bad situation.

I read the reply before I came to the Chamber and it contains devastating news for them. I understand what Deputy Harkin said. It necessitates a three-hour journey from some parts. We all know how time is so important. I will bring their concerns back to the Minister, Deputy Stephen Donnelly. I will listen to what they have to say again now.

Marian Harkin (Sligo-Leitrim, Independent)
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I do not doubt the sincerity of the Minister of State. I have read the answer which stated that the HSE advised that all options had been explored. What were those options? When did they know? What did they do? We are getting absolutely no information. The Minister of State spoke about when she was first elected to the House. Back in 2018 a colleague of hers, the former Deputy, Eamon Scanlon, raised this issue here. He also said that not having a permanent cath lab in Sligo has serious implications for the recruitment of an additional cardiologist. Everybody in Sligo knows that is staring us in the face right now. It is not just the cath lab.

This answer tells us that strong clinical links are in place between Sligo and Galway. The Minister of State said it takes three hours to get there from some places. That is the median time. The longest time is between five hours and six hours. I did not quote the longest time. I do not blame the Minister of State personally. She read out what she was given. I have heard one excuse after another. It is time we got answers. We need them.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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I am very disappointed with the answer that the best the HSE can do is to provide a temporary service in Galway. A service existed in Galway anyway. This is not something new. There is a cath lab in Galway. It is totally inappropriate to suggest that is the best that can be done. Why can a temporary cath lab not be supplied in Sligo now? Why can that not be the plan? There is no mention of anything happening in Sligo University Hospital.

A previous Topical Issue discussed a school operating in temporary accommodation for the past 11 or 12 years. Temporary can very quickly become semi-permanent and totally inadequate. We fear that is what will happen with this. The clear message from the people of the north west is that the Government needs to step up to the mark on this issue. We cannot be left without a cath lab service in the north west and in Sligo University Hospital. It must be put in place. There are no excuses. There is no other way of doing it. It must be put in place. I appeal to the Minister of State to go back to the senior Minister and express those views. These are not just the views of Deputy Harkin and me. They are the views of all the other Deputies, representatives and people of the north west who feel very let down and very cross about this situation. The Government simply must deliver it and do so now.

Mary Butler (Waterford, Fianna Fail)
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I can understand how upset, annoyed and disappointed the Deputies are about what has transpired. We have had many conversations about cardiac supports and how important they are. As I outlined earlier, the HSE has advised that all options have been explored regarding the continued provision of cath lab services in Sligo University Hospital after the cessation by the current service provider later this month. It will exit the Irish market completely at the end of June which is very disappointing. I know the Deputies are disappointed with the answer and with the detail it contained. They can rest assured that I will bring this back to the Minister, Deputy Stephen Donnelly.

I can go through the response and tell them what has been provided in Galway. I understand that we also need a good service in Galway. We need services everywhere, especially cardiac services. I understand completely. We have had an enormous battle in the south east for many years. I know the Deputies in the north west have been raising it and have all come together as a collective. I will certainly pass on their concerns. I have no doubt this will be raised again on the floor of the Dáil.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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It is an example of the failure of a private provider doing something. It can turn its back and walk away at any time. The State has to step up to the mark on these issues.

Marc Ó Cathasaigh (Waterford, Green Party)
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We have not provided for an extra contribution.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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I am chancing my arm.