Maura Hopkins (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State at the Department of Health, Deputy Finian McGrath, for taking this Commencement matter. I am sure he is very well aware of the issue with the thrombectomy machine because it is situated in Beaumont Hospital, which is in his constituency. I raise this matter because I have worked with stroke patients for a number of years as a healthcare professional. I am very much aware of the positive impact thrombectomy services can have on people. In many cases it is the most effective life-saving treatment for stroke patients.

Evidence clearly indicates that thrombectomy services can reduce stroke deaths by half and reduce the rate of permanent disability by a similar amount. I cite this evidence because it is from the ESCAPE trial in which Beaumont Hospital was involved with many other countries across the world to try to provide evidence of the effectiveness of this service. However, due to the poor condition of the equipment in Beaumont Hospital, patients' lives are being put at risk. I have become aware from the Irish Heart Foundation that the thrombectomy machine being used in Beaumont Hospital is not fit for purpose in a modern health service. The machine has broken down on many occasions and, worryingly, it has also broken down while patients have been in receipt of treatment.

I should outline what a thrombectomy is. It involves a tube being inserted into an artery in the groin which travels through blood vessels to the brain, monitored and guided by X-ray. It sucks up the clot from the brain and restores blood supply. It is very worrying, therefore, that this thrombectomy machine is not fit for purpose in the first place and is also breaking down when patients are receiving treatment.

I am seeking an update from the Minister of State in respect of ensuring a new machine will be installed and that there will be further expansion of this service in Beaumont Hospital. There is a similar service in Cork.Some 248 patients benefitted from the thrombectomy services at Beaumont Hospital in 2017. I have been informed in writing by the chief executive of the hospital that it is admitted that patients have received substandard treatment. This is really not acceptable. We know this service can have a positive impact on many people. I understand it would cost approximately €1.5 million to replace this machine. This must be a priority, especially given that we will put €17 billion into our health service next year. We must ensure stroke patients get an excellent service that includes the modern and up-to-date treatment they require. We must support them in seeking to reduce the onset of disability-related limitations. We know there is strong evidence of the positive benefits of thrombectomy services. I ask the Minister of State to update the House on when we will see this new machine being put in place.

Finian McGrath (Dublin Bay North, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for raising this important issue. I am aware of her work as a health professional. I have listened carefully to everything she has said. I will take on board all the points she raises during this debate.

I am pleased to have an opportunity to update the House on the thrombectomy service in Beaumont Hospital. It is estimated that every year, some 10,000 people have a stroke-related event and some 2,000 people die as a result. Thrombectomy is an emergency endovascular procedure that is provided under radiological guidance to remove clots from patients with severe strokes using specialist devices. There is strong evidence of improved outcomes for patients who undergo thrombectomy treatment, which can be life-saving and can prevent serious disability.

As Minister of State with responsibility for disability services, I take this very seriously. The provision of emergency endovascular thrombectomy is highly specialised. Mechanical thrombectomy procedures are provided by specialist neuroendovascular radiologists in Beaumont Hospital and Cork University Hospital. The number of patients undergoing this procedure has been increasing each year. There were 122 cases in 2015, 172 cases in 2016 and 280 cases in 2017. The HSE has indicated that two new biplane neuroangiographic imaging systems are required because the existing systems are at the end of their lives. This project includes the replacement of the existing biplane angiograph imaging system, the provision of a second biplane angiograph and the associated building works necessary to accommodate the second machine. The simple replacement of the existing machine would result in a discontinuation of service for a prolonged period, thereby necessitating the installation of a second device. It is estimated that the project will cost €6.688 million, with a project timeline of 24 months.

The HSE is responsible for the delivery of health infrastructure projects. All proposed projects must be submitted to the HSE's capital and property steering committee for approval and prioritisation prior to inclusion in multi-annual capital plans. A submission for the development of an expanded neurointerventional radiology service at Beaumont Hospital was received by the HSE national capital and property steering committee in February 2018. The submission for expanded services at Beaumont Hospital is supported by the HSE acute hospital directorate and is recommended for inclusion in the capital plan.

The HSE is developing its national service plan and capital plan for 2019. It is aware of the need for the development of the thrombectomy service at Beaumont Hospital. The HSE will consider this development in the context of planning for 2019 within available funding and the process in place for the agreement and prioritisation of projects in the capital plan. All projects such as the proposed thrombectomy service development must comply with national and EU spending and procurement requirements. They require a lead-in time to complete the various development stages, including appraisal, design, planning, tender, construction and commissioning.The Government is committed to making tangible and sustainable improvements in our health services. The Department, the HSE, the RCSI hospital group and Beaumont Hospital are supportive of the project to develop thrombectomy services at the hospital, and the need for this capital development is recognised in supporting the delivery of this key service to patients. It is an absolute priority for me as well.

Maura Hopkins (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State. I have two questions. I refer to the response with regard to the HSE, and I am aware of this issue from asking previous questions on it. The Minister of State said that the HSE will consider this development in the context of planning for 2019 and he mentioned the prioritisation of projects in the capital plan. When will we know that funding has been allocated to ensure that we have new thrombectomy services in Beaumont Hospital, particularly as the Minister of State said that he knows the evidence is clear that thrombectomy services are critical in ensuring that we reduce the level of disability for people and reduce mortality rates?

Having worked within the stroke services, I know that some improvements have been made but it is not enough. The Minister of State said in this response that the Government is committed to making tangible and sustainable improvements in our health services. I want the Government to be committed to ensuring that it makes improvements in our stroke services. The point I am making today is that we need to see a new and expanded thrombectomy service in Beaumont Hospital to ensure we support as many stroke patients as possible.

Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

We are way over the time limit, so I ask the Minister of State to be brief.

Finian McGrath (Dublin Bay North, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Senator again for raising this important issue. The 2019 service plan will be finalised in the coming weeks. I know that from my own portfolio of disabilities so the answer to the Senator's first question is that it will be in a matter of weeks.

The second point the Senator raised was a very important one. We need to make improvements in the stroke services and I will bring that point back to the Minister. This service works and we have seen it work. The Senator knows that from her previous work as a health professional and I know it from talking to staff, doctors and patients in Beaumont Hospital. The hospital is only a few hundred yards from my home, so I know exactly what the Senator is talking about. We need to expand the services and I am committed to that. The Government is committed to supporting the hospital to develop its services in the future. This commitment is recognised in the programme for Government and the partnership plan.

Beaumont Hospital has a reputation for the delivery of high quality and safe care for its patients. The development of the thrombectomy service will support the delivery of key services to patients served by Beaumont Hospital. I will make this a priority issue and report back to the Minister. I will also keep an eye on it for the HSE 2019 service plan.