Noel Grealish (Galway West, Independent)

I thank Senator Kennelly and I have been asked by the Minister for Health to respond to his Commencement matter. I thank him for facilitating this opportunity to discuss this important matter of cardiac screening for young athletes.

Ireland has very robust procedures in place for the introduction of new screening programmes. Any proposed changes to Ireland’s screening programmes will be facilitated through established evidence-driven protocols. The national screening advisory committee, NSAC, is the independent expert group which considers proposed changes to screening programmes or the introduction of new screening programmes. The NSAC assesses the evidence robustly and transparently and against internationally accepted criteria before making recommendations to the Minister for Health.

All screening programmes have both harms and benefits, so these NSAC processes ensure recommendations are based on solid evidence. This is critical to maintaining rigorous processes for effective, quality-assured, and safe screening programme standards. I must emphasise that any changes to Ireland’s screening programmes will always be based on the evidence. The NSAC holds calls for submissions, which invite proposals from all stakeholders and organisations, including members of the public, the HSE and other medical professionals, for the introduction of new screening programmes or changes to existing programmes. The next call for submissions will open shortly. Regarding sudden arrhythmic death syndrome, the cause may be related to underlying cardiac disease, inherited cardiac conditions or may remain unknown.

Children’s Health Ireland, CHI, at Crumlin provides targeted screening and ongoing care of children identified at high risk of or affected by an inherited cardiovascular condition, ICC. Children are primarily identified based on wider family history in partnership with, first, the family heart screening clinic, FHSC, at Heart House, Mater Misericordiae University Hospital and, second, cardiac risk in the young, CRY, at Tallaght University Hospital. CHI at Crumlin, along with FHSC and CRY, work together and as a combined entity are a recognised centre of European excellence for the care of ICC families with accreditation through the European Reference Networks.

The national review of adult specialist cardiac services was published recently. The review provides a detailed, evidence-driven analysis of adult cardiac services. The review provides 23 recommendations around cardiac health policy. The report gives us the data and roadmap reform of cardiac services, and the Minister is ambitious to progress this important work. Specifically, the review recommends that services for inherited cardiac conditions be provided as a national service, with strong links to regional cardiology centres and supported by genetic services aligned with a national clinical genetics service. The Minister has written to the HSE to begin developing an implementation plan for the review’s recommendations. This will be a key facilitator of our new national cardiovascular strategy as promised in the programme for Government.

Enhanced community response is critical to improving cardiac arrest survival rates, and this is wholly recognised in the National Ambulance Service’s out-of-hospital cardiac arrest strategy. The National Ambulance Service has a network of more than 250 community first responder schemes, supported by the community engagement team. In the event of a cardiac arrest, automated text messages direct community first responders to the scene of any cardiac arrest that occurs in the catchment area. The Government is committed to ensuring that Ireland continues to improve out-of-hospital cardiac arrest survival rates. Work is already in progress to implement the National Ambulance Service's national AED - defibrillator - registry, which will be mapped to the National Ambulance Service dispatch system and a supporting app for dispatching first responders.