Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Senator Cullinane for raising this matter today.

Services at the regional cardiac catheterisation laboratory, cath lab, at University Hospital Waterford are led by three consultant interventional cardiologists and their teams.The service is developing in line with best practice and the national clinical programme for acute coronary care. The cath lab at University Hospital Waterford, UHW, performs approximately 40 invasive cardiovascular procedures each week and offers a comprehensive range of invasive and non-invasive diagnostic services. This includes the insertion of stents, pacemakers and implantable defibrillators. PPCI is undertaken on patients with ST elevation myocardial infarction, STEMI, heart attacks, which account for approximately 20% of all heart attacks. It is done in a cath lab by an experienced cardiologist. The cath lab at UHW is open five days per week from 8.30 a.m. to 5.30 p.m. Patients who require PPCI outside these hours are transferred to Cork University Hospital or to a Dublin hospital. However, 24-hour, seven-days-a-week consultant medical cover for cardiac patients, and all medical patients, is provided at UHW.

The acute coronary syndrome programme was established in order to standardise the treatment of patients. The model of care produced by the programme was informed by advice from the principals involved in centres in the UK and other European countries. Experience at national and international level highlights the importance of having sustainable rotas of clinical staff to support the 24-7 requirements of the service. UHW is committed to the progressive extension of the current PPCI service. Any extension to the service will require significant investment, both capital and revenue.

To provide 24-hour emergency PPCI cover requires, at a minimum, two cath labs on site and a minimum of six interventional cardiologists. As for any complex acute hospital service, a key criterion for deciding if a 24-hour PPCI service should be provided is whether there is a sufficient volume of appropriate patient activity to ensure the safe provision of the service. Without sufficient volume of patients or caseload, staff will not be in a position to maintain their skills, and in those circumstances it will not be possible to ensure a safe service with good patient outcomes. Given that funding for new developments is very limited, it is critically important that the available funds be targeted appropriately. UHW is a constituent hospital of the south-south west hospital group. The priority to be afforded to the expansion of the PPCI service in Waterford must first be considered from a hospital group perspective and in respect of the planning for the cardiology needs of the group population. The development must then be considered in a national context and in light of competing demands for scarce resources. The issue remains to be considered and prioritised by the HSE, in the development of the strategic plan for the south-south west hospital group. It is expected that the groups will develop and complete their strategic plans in 2016.