Seanad debates
Thursday, 15 November 2018
Commencement Matters
Hospital Services
10:30 am
Frank Feighan (Fine Gael)
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I welcome the Minister of State to the House again today. It is always nice to see him. He has had a great interest in health over a number of years. My Commencement matter is the need for the Minister for Health, Deputy Harris, to provide an update on plans for a fixed catheterisation laboratory, cath lab, at Sligo University Hospital. For many years, my colleague, Deputy McLoughlin, has campaigned strongly for such a lab. This facility is vital. It provides a diagnostic service for patients with suspected heart disease or heart attacks. The hospital is currently served by a mobile cath lab, which provides services one day a week for elective procedures only.
There are also a number of cath labs in Galway that serve acute cardiac cases for Sligo and the north-west region. I understand that, in addition to the numbers treated in Sligo University Hospital, the hospital refers approximately 300 patients each year to St James' Hospital and the Mater Private Hospital. There is, however, now a compelling need for a permanent cath lab in Sligo. There is a critical 90-minute window in the event of someone having a heart attack. For those living in Sligo and the north west, this is a major challenge.
Accessing the timely care needed has been hindered by geography and the road infrastructure but more importantly, the lack of access to life-saving cardiac services. It takes at least two hours to travel from Sligo to Dublin by ambulance and a similar length of time to travel to Galway. There is an air ambulance which can get a patient to Galway or Dublin quickly but it may not always be available. It is clear to me that those living in Sligo, Leitrim, north Roscommon, south Donegal and west Cavan deserve a fixed cath lab. Cardiac patients will otherwise continue to be challenged by having to travel long journeys to receive the care they need.
There has been some progress on the issue of a cath lab at Sligo but it is extremely slow. A business case for a fixed facility has been submitted nationally and I understand this might not be advanced until the national review of cardiac services is completed. The Minister of State might shed some light on this and when this review is likely to be completed. I have to ask a question which has been posed many times. Why should cardiac patients in the north west be forced to go on long journeys to Galway or Dublin? What benefits can there be in this for a heart attack patient in this region? I must also highlight a clear cost element. In the past 15 years, I understand that the Health Service Executive, HSE, has spent €10.5 million transferring 550 cardiology patients each year from Sligo to Galway or Dublin. In addition, €3.6 million has been spent over this period renting a temporary visiting lab in Sligo. Why can the HSE not invest the money in the provision of a fixed cath lab?
Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Feighan for raising this important issue. He is committed to developing and expanding health services, particularly in the west of Ireland and, in this case, in Sligo University Hospital. It is an important issue and it gives me the opportunity to provide an update. The Government is committed to ensuring that all citizens have access to safe, high quality and evidence-based care in line with international norms. Sligo University Hospital provides high quality healthcare to the people of Sligo, Leitrim, south Donegal and west Cavan. There are currently two cath labs based in Galway, which service acute cardiac cases for Sligo and the north west. For elective cases, a mobile cath lab unit operates for one day a week in Sligo and Letterkenny.
The 2013 report of the north-west cardiology review group recommended that opportunities presented by the proximity of Altnagelvin Hospital to Letterkenny should be explored to see if co-operation arrangements could be agreed. This recommendation has now been implemented. There is a cross-Border arrangement with Altnagelvin Hospital in Derry to provide cath lab services and primary percutaneous coronary intervention, PCI, to people in the north west. That is something that has come up in recent days as well in the broader Brexit debate. It is important that such cross-Border arrangements are continued and especially in respect of health issues. It is also important to note that specialist cardiac catheterisation lab services are provided in a small number of hospitals in order to ensure that the services provided achieve the required standards of safety, quality and sustainability in the interests of patients.
Earlier this year a steering group was established, chaired by Professor Philip Nolan, to undertake a national review of specialist cardiac services. The steering group comprises 15 members including health professionals, patients, HSE management and officials from my Department. The review will also consider the responses gathered from a public consultation. I am sure that will include the views of the people of the north west and people throughout the country who responded. This consultation is in keeping with the Government’s commitment to incorporating the views of our citizens.
The aim of the review is to achieve optimal patient outcomes at population level with a particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service. The review will incorporate rigorous reviews of evidence and data, international peer review and stakeholder consultation. This review began on 31 January and is ongoing. It is expected that the work will be completed by the end of June 2019. I expect the review will provide a blueprint for the future of adult cardiac services. As set out in the National Development Plan 2018-2027, investment in cardiac catheterisation laboratories, and other cardiac services infrastructure nationally, will be informed by the outcome of the national review.
Frank Feighan (Fine Gael)
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I thank the Minister of State for his reply. This review is rigorous with evidence and data. I know there are stakeholder consultations but the review started on 31 January and will not be complete until June 2019, which means it will have taken a year and half. I am not familiar with the complexities but that seems like a long time to have a review. I look forward, however, to seeing the results of the review and I hope we will have a cath lab in Sligo in future.
Finian McGrath (Dublin Bay North, Independent)
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I again thank Senator Feighan for raising this issue. I understand its importance in the north west. I also understand his point about the long journeys. That is not acceptable. We have to plan services in order that they are patient-centred and that is particularly the case with cardiac patients. I take the Senator's point on that and on the review. I will bring those points to the Minister for Health. I assure Senator Feighan that the provision of a cath lab in Sligo University Hospital is being considered under the national review of specialist cardiac services. That is due to be completed in June 2019. I will bring the two key points which Senator Feighan raised to the Minister, Deputy Harris and push that matter.