John Cummins (Fine Gael)
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The expansion of cardiac services at University Hospital Waterford, UHW,is a topic on which the Minister of State, Deputy Butler, and I have worked continually because we are acutely aware of the need and the impact it has on our constituents in Waterford and the wider south east region. We have worked collaboratively along with other public representatives and campaign groups on a cross-party basis to advance the provision of cardiac services at UHW. It is a touchstone issue that is at the forefront of many people's minds in Waterford. This is a good thing because the people of Waterford and the south east deserve equity of access when it comes to life-saving cardiac interventions in the same way as people in other regions have.

It is for this reason that the then Minister for Health, Deputy Simon Harris, approved, the construction of the second cardiac cath lab at UHW at the end of 2018 against the advice of officials because he and the Government believed in the case that was being put forward by UHW, which was that in order to adequately treat patients in the south east in a timely fashion, a second cath lab was required as a first step to expanding services which, at the time, only operated from 9 a.m. to 5 p.m., five days a week.

During the lifetime of this Government and the previous one, considerable extra resources have been provided to increase the level of cardiology services at UHW. Prior to the opening of the second cath lab, a service-level agreement was in place at UPMC Whitfield Hospital to provide additional hours to assist with cardiac diagnostics. This service then returned to UHW with the opening of the second cath lab in UHW in September 2023. We now have two cath labs operating from 8 a.m. to 8 p.m. five days a week, which has has a really positive impact on service availability and has led to a significant reduction in the waiting list. Indeed I understand that we now have one of the lowest waiting lists in the country for cardiac procedures.

In her response in this House to me on the same topic in December 2023, the Minister of State confirmed that 22 of the 24 additional posts were already in place and the focus was very much on how we move to the next phase of development, namely, moving to 8 a.m. to 8 p.m. seven days a week. While some political representatives wrongly stated at that time that the embargo would prevent further expansion of services, we both said that it would not because the case to have that allocation in the 268 whole-time equivalents that were approved by Government for this year had been successfully made by the Minister and us as Government representatives.

When I was mayor, I remember hosting an engagement with the consultants at UHW regarding primary percutaneous coronary intervention services at UHW. It was said at that time that up to 95% of cases would be covered by 8 a.m. to 8 p.m. seven days a week services so it is a significant leap forward to get to that point. When does the Minister of State envisage having that 8 a.m. to 8 p.m. seven days a week cardiac service at UHW? Will management have to have the additional 22 posts approved and in place before we can move to that or can we get to that level of service while the recruitment is ongoing?

Mary Butler (Waterford, Fianna Fail)
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I thank Senator Cummins for giving me the opportunity to update the House on this matter, a really important issue on which the Senator and I have worked tirelessly for many years. The Minister for Health and I are fully committed to supporting our cardiac services nationally and cardiovascular health in general, which is a valuable part of our health service.

I acknowledge the commitment made by this Government recognising it has invested significantly in UHW. I also acknowledge the significant developments in cardiac services delivered by UHW and commend the staff on their continued commitment and dedication to providing specialised cardiac care. I stand here proudly in this House with the Senator asking the question and speak about the pride we have in UHW, which is one of the best performing hospitals in the country.

In 2019, University Hospital Waterford had a budget of €201 million. In 2024, that budget is more than €290 million, meaning it has grown by €89 million. That is a 44% increase in the lifetime of this Government. This is only right as there are more pressures on acute hospitals to deliver more services. We have an ageing and growing population.

UHW is the largest employer in Waterford city and county. Staffing at the hospital has grown by 841 since the end of December 2019, from 1,949 to 2,805 in May. This represents an increase in staffing of 44%, including 47 more consultants, 100 additional non-consultant hospital doctors, 370 more nurses and midwives, as well as 123 additional health and social care professionals. As part of this investment in workforce increase, there has been a focus on developing cardiac cath lab services at the hospital. In September 2022, the opening hours for the original cath lab in UHW were extended to 8 a.m to 8 p.m. from Monday to Friday, excluding bank holidays.

I am pleased to say that the programme of Government committed to a second cath lab in UHW, with a capital investment of almost €8 million. The second cath lab opened on 4 September 2023 and operates five days a week, Monday to Friday, from 8 a.m. to 6 p.m. Notwithstanding the difficult recruitment environment impacting the healthcare sector, 24 whole-time equivalents were provided to support the opening of the second cath lab. They were all in place in 2023. There were 37 whole-time equivalents approved to support initiatives at UHW. These were included in the first round of new development funding for 2024 and in the pay and numbers strategy for 2024. Permission has been granted by the Minister to commence recruitment for these positions and it is now an operational issue for the HSE to do so.

On Tuesday morning, I spoke to the general manager, Mr. Ben O'Sullivan, who was pleased to have received sanction to commence recruitment immediately to implement weekend cover in the cath lab. I also had that confirmed by Mr. Damien McCallion, HSE chief operating officer, who has oversight of the pay and numbers strategy. There has been criticism that some timelines have been lost, but I operate in good faith with the information I receive. I have a duty, as does the Senator, to inform the public in Waterford on what is a matter of huge importance to us all. I cannot withhold the information and just see what happens. I was given the information in good faith at the start of the year. Unfortunately, it has taken longer than we would have liked for the pay and numbers strategy to filter down to the hospitals. The good news is that recruitment is commencing immediately. Having spoken to the general manager of the hospital, his indicative timeline is a three-month focus to have services in place some time in October.

John Cummins (Fine Gael)
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That is the key issue. It seems from the Minister of State's discussions with Mr. O'Sullivan that we can get to that level of service while the recruitment is ongoing. Obviously, these are highly skilled individuals who are not waiting around for a phone call to take up a post at UHW. It is good that we will be able to move to that level of service while the recruitment proceeds at the same time. As I have said previously, there is not much grasp of the level of vested interest in play here, both in the medical space and further afield. There are those who did not and still do not want this service to expand at UHW. The Government has always had the political will and determination to get to this significant level of service, namely, 8 a.m. to 8 p.m. provision with weekend cover. As I said, when I was the mayor of Waterford, consultants would cover up to 95% of all cardiac cases, which is a significant leap forward. Given their throughput and the work done in the two cath labs, I am confident they will demonstrate a need to build further in the time ahead.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator and also acknowledge our colleague, Deputy Ó Cathasaigh. People step up to the plate and become a part of the Government. When that happens, their job is to deliver. Working constructively together, I believe that we are delivering. We are not where we want to be yet, but we are moving quickly in that direction. Considerable progress has been made. We had a single cath lab which was a point of failure that broke down regularly. We all remember there was a mobile unit three days a week for diagnostic services. Now we have two state-of-the-art cath labs. We have a service from 8 a.m. to 8 p.m., Monday to Friday, 24 new staff since 2023, and weekend service recruitment commencing this week.

Sometimes there is a misunderstanding and there are criticisms, but there are difficulties to be faced in progressing these issues. This week, UHW became one of the first hospitals under the pay and numbers strategy to have recruitment sanctioned. I thank the Minister for Health, Deputy Donnelly, and the Taoiseach for all their work in supporting us. We are not there yet but we will get there. This is a good news story notwithstanding what people will say.

Mark Daly (Fianna Fail)
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I thank the Minister of State for coming to Seanad Éireann on behalf of the Department of Health.