Grace O'Sullivan (Green Party) | Oireachtas source

The tragic death of Thomas Power has shown us that we cannot wait any longer - not for another review, not for another mobile cath lab that should already have been delivered by now, and not for more excuses. People have died and more will die unless the Government takes action necessary to deliver a safe and adequate health care system to the region. I have been talking to public representatives from across the region, councillors, Deputies and Senators from all parties and none in an effort to build support for a depoliticised approach that serves the region best.

I have also contacted consultants at University Hospital Waterford, those at the coalface of this crisis. They have a very clear and detailed analysis of what needs to be done, some of which I want the Minister to hear today. Their analysis is as follows. First, the south east region is the only region nationally without a 24-7 cardiac care service. Statistical analysis from studies compiled in the UK and Europe using similar demographics is compelling and demonstrates that the lack of a service in the south east is causing 6.3 deaths per year. Second, multiple worldwide clinical assessment of primary emergency coronary angioplasty and stenting for ST elevated heart attack has been demonstrated to be only effective if carried out soon after the first presentation of symptoms of a heart attack. After 90 minutes the benefits of primary PCI are negligible as heart muscle starved of oxygen and blood supply has already died and is not replaceable. Third, the cath lab at University Hospital Waterford in 2015 dealt with approximately 64 such events during open hours while 75 were sent outside the region for treatment. Fourth, referring patients to outside centres where travel times can be double the European standard of 60 minutes is proving to be a clinical sub-optimal treatment protocol.

Fifth, loss of heart muscle due to delays in assessing emergency care leads to both deaths and increased morbidity for survivors. The south east has many patients who have suffered damage and loss of heart muscle. Their resulting health profile and quality of life are severely impacted as a result. They are an increased drain on scarce health resources as they are forced to engage more often on an ongoing basis with primary and hospital services due to their compromised health status. This health discrimination is perpetrated on no other citizenry in the country.

Sixth, as evidenced by RTE Radio 1 coverage recently of this issue, a large number of people in the region suffer huge anxiety and stress as a result of having received previous cardiac treatment or having clinical conditions without treatment within 90 minutes travel time. These patients are well aware that their prognosis in such cases is probably a fatal outcome. Seventh, the subsequent recommendations of the Herity report to completely remove all emergency cardiac access at University Hospital Waterford and, furthermore, to remove all elective PCI procedures will significantly impact the direct provision of high value, acute medical services within the south-east region. Eighth, the Waterford cath lab is one of the most efficient in the country, despite its 37 hours per week restriction and it has one of the highest throughputs in patient procedures nationally.

The recommendations of the Herity report with respect to this centre are illogical and misdirected in terms of any measure of quality health care, economic impact or social deprivation one wishes to mention. There is no viable or feasible substitution for dealing with the south-east issue other than to immediately provide a second cath lab with the full medical attendant complement required to provide a comprehensive south east region cardiac rescue and elective service. The clinical case for this has long been made and recent events should now stimulate all elective representation of 24/7 care for the south east region. If the Department of Health wishes to review cardiac services on a national level, it should begin by concentrating on the less efficient labs that exist in the country and review the Waterford based service after one year's operation as a 24-7 centre. The current review pathway chosen by the Government will take at least a year to arrive at a conclusion. That is not worth 6.3 deaths while the south east waits.

I am standing here on behalf of people from the south east, from Waterford, and on behalf of the Power family. What happened recently is a disgrace. It is such a tragedy. Something must be delivered now, not a review but a 24-7 centre in Waterford.