Mary Butler (Waterford, Fianna Fail)
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314. To ask the Minister for Health his views on whether the south east region is the only region nationally without a 24/7 cardiac care service; and if he will make a statement on the matter. [33278/17]

Mary Butler (Waterford, Fianna Fail)
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316. To ask the Minister for Health his views on whether referring heart attack patients to outside centres where travel times can be double the European standard of 60 minutes is proven to be a clinical sub-optimal treatment protocol (details supplied); and if he will make a statement on the matter. [33280/17]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 314 and 316 together.

Primary PCI is recognised internationally as the preferred treatment of STEMI in terms of morbidity and mortality outcomes. Highly specialised services such as primary PCI need to be carried out in a small number of hospitals, where the volume of patients supports the provision of a safe service. Low volume services do not facilitate the ongoing and sustainable achievement of the patient outcomes required. Based upon this country's population, we can only operate a limited number of primary PCI centres in order to ensure that the services we provide achieve the required standards.

Across the country, patients are transferred to cardiac centres for primary PCI. For example patients in Louth are transferred to Dublin, patients in Kerry go to CUH or Limerick. As the Deputy is aware, primary PCI is provided at University Hospital Waterford from 9 am to 5 pm, Monday to Friday, and patients are transferred to CUH or to St James's Hospital Dublin for primary PCI outside of these hours. Where primary PCI cannot be delivered within an acceptable timeframe, thrombolysis is recommended with early transfer to a primary PCI centre for angiography. My aim is to ensure that as many patients as possible have access on a 24/7 basis to safe and sustainable emergency interventions following a heart attack and, accordingly, I have asked my Department to make arrangements for a national review of primary PCI services to be undertaken, based on independent clinical expertise.

Mary Butler (Waterford, Fianna Fail)
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315. To ask the Minister for Health his views on whether in multiple worldwide clinical assessments primary emergency coronary angioplasty and stenting for ST elevated heart attack has been demonstrated to only be effective if carried out soon after the first presentation of symptoms of heart attack, as after 90 minutes the benefits of primary PCI are negligible as heart muscle starved of oxygen and blood supply has already died and is not replaceable; and if he will make a statement on the matter. [33279/17]

Simon Harris (Wicklow, Fine Gael)
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As this is a matter relating to the clinical management of myocardial infarction, this question has been referred to the HSE for direct reply.