Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I have heard that this is just an issue for the south east but that is not the case. There is no PPCI centre in the midlands. Patients in Monaghan, Louth, Kerry, some patients in parts of my own constituency of south Wicklow, and patients in Sligo all travel for significant lengths of time to access services. I make that point because while it is a significant concern in the south east, equally, there are other parts of the country that have concerns about the location of PPCI services. That is why it is appropriate that we now examine the geographical spread of primary PCI centres to ensure that as many people as possible have access to this procedure in a timely way and that it is done in a fair and equitable way. We should examine the current geographical spread of facilities to decide if that is appropriate. That is the benefit of a national review in that we are not just talking about Waterford but all of the country and the division of PPCI centres in a fair manner based on clinical evidence.

There is a clear need to design the best future reperfusion protocol for patients who live outside the 90 minute transfer window, for the very reason Senator O'Sullivan outlined. This may be to thrombolise patients, in other words, to use clot busting drugs before transferring a patient to a cath lab. It might be in the area of helicopter transfer of such patients, an issue Senator Coffey has raised with me, or an alternative strategy, but we need to do this work, and we will.

In 2012, long before my appointment to this role, the Health Service Executive’s acute coronary syndrome clinical programme set out the model of care for acute coronary care and designated a number of cardiac units as 24-7 or 9 a.m. to 5 p.m. centres. It is timely to look again at how we deliver primary PCI services on a national basis to ensure that as many of our citizens as possible have access to what we all want them to have access to, namely, a 24-7 basis to primary PCI.

I am committed to and am announcing a national review, which will examine these issues and future configuration of primary PCI services in the south east, including the number and location of the centres required to serve our population needs. I have asked my Department to make arrangements for this national review, which will be undertaken based on independent clinical expertise. I cannot stress the importance of that independent clinical expertise. The review will also address the wider implications for all parts of the country regarding primary PCI services and devise a plan for the achievement of the best patient outcomes possible, and one that reflects patient safety as a paramount concern.

I repeat that extra investment is being provided to allow additional activity. The mobile cath lab is confirmed; it is on the way. I accept there was a tendering delay by the HSE. There will then be a review of the additional investment specifically relating to the south east to see if the question Senator Coffey asks is valid, namely, do attendances increase when hours are extended and more services are put in? There will also be a national review recognising the importance of having a fair, equitable and clinically based decision making process in terms of the location of 24-7 primary PCI centres across the country to provide services for the greatest number of our citizens possible.

I am committed to keeping in touch with the Senators and the Deputies from the south east as we develop this process.