Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Senators for their contributions to this discussion this evening, all of which I take on board.Members have been passionate, strong and genuine in their views and concerns about this issue, and I acknowledge that. The point Senator Coffey makes is valid. This is not a party political issue and I do not intend to approach it in such a way or in an argumentative way. This is an issue on which I accept the bona fides of all Senators, and Deputy Butler, regarding this matter. Undoubtedly, Mr. Power's death was extraordinarily tragic. My heart goes out to his family and my thoughts are with them at this sad time. I cannot imagine the terrible grief being experienced by his wife and by his family and friends. While as I said in my opening statement that I cannot comment in detail on individual cases, I want to reiterate on the record of the House that I expect that all the appropriate procedures relating to the examination of the circumstances of Mr. Power's death will be undertaken. It is vital that that happens and that all of the procedures can be examined in full so that information can be provided to the Power family on what happened to their beloved Thomas.

As Minister for Health, I have to base my decisions on clinical evidence and, in fairness, I think everybody in the House accepts that. As I mentioned earlier, I commissioned the Herity report last year to look at cardiology services in University Hospital Waterford. The report was undertaken by one of the foremost cardiologists on these islands, a doctor of international repute. While people in this House are entitled to their views, I believe everyone would acknowledge that Dr. Herity is a world renowned cardiologist.

I have heard a good deal of commentary in recent days to the effect that for a certain amount of money this facility could be opened on a 24-7 basis. I want to be very clear for the people of the south east. This is not a budgetary matter. In fact, when we put together A Programme for a Partnership Government it referenced providing this service, subject to a clinical review. That was also accompanied by a signed letter from the Minister for Finance, which was published at the time, promising that the funds would be provided. In debating this issue, let us park that aspect because it is not a budgetary matter. If there was clinical evidence that this second cath lab and a 24-7 service should be provided, the funding would be provided by this Government. It is a relatively small amount of funding so it is not a funding issue.

We cannot plan services based just on our views. We have to plan them based on medical evidence. We have a long tradition of doing that in a number of areas. A number of my predecessors from different political parties also found themselves having to make very difficult decisions relating to the provision of centres based on expertise and specialisms. We must take a similar approach to cardiology. Primary PCI is a highly specialised procedure requiring great clinical expertise. Clinical staff need a sufficient throughput of patients to maintain their skills and thus ensure that a safe service is provided. Not just in Ireland but internationally, the trend is towards consolidation of such specialised services on a smaller number of sites to allow for the concentration of volume and expertise. I need to make two points in that regard, not in an argumentative way but in a factual way.

I hear much talk about 500,000 people in the south east. The evidence in the Herity report was that when we look at the trends, many of those 500,000 people were going to different locations, be it Dublin but primarily Cork. If that evidence changes and more people start going to the service, the figures may change when it is reviewed again.