Dáil debates

Thursday, 3 October 2024

Ceisteanna ar Sonraíodh Uain Dóibh - Priority Questions

Health Services

10:30 am

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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1. To ask the Minister for Health when he will publish the national review of specialist cardiac services; and if he will make a statement on the matter. [39373/24]

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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In 2019 I attended a meeting with the then Minister for Health, Deputy Simon Harris, and Oireachtas Members from all parties in the south east. At that meeting the then Minister for Health committed to a national review of cardiac care. It was to look specifically at cardiac services in the south east, but also at wider services. I know that was disrupted by Covid and the work Professor Nolan subsequently did in the National Public Health Emergency Team, NPHET. My understanding is that the report has been with the Minister for Health for some time. When did the Minister receive the report and when does he intend to publish it?

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy for the question. The national review of adult specialist cardiac services is finalised and I have received the report. I do not have the date but I have received it and I will move to publish it very shortly. I want to bring it to Government. It is a very good and comprehensive report. One of the reasons I did not publish it right away was I did not want to publish a review that did not have any money behind it.

The report makes a lot of recommendations. Additional funding for cardiovascular services is required. I wanted to wait to make sure I had money to back all of this up. That is what the budget was about in this particular area. As the Deputy will be aware, we put a big focus in the budget on cardiovascular disease, which is still one of the biggest killers in the country. Unlike cancer care, women's healthcare and other areas, it has not had the strategic investment, with a plan, that it badly needs. This week I have put a cardiovascular health package together in the budget, with an allocation of €8 million. This includes €600,000 for the all-island congenital heart disease network; €4 million for 45 posts for the first year of the review so we can get on and hire the extra cardiologists and put the extra services in place; and €4 million to support the expansion of early supported discharge teams and, critically, access to acute stroke units, so the stroke strategy has been funded as well. I have also allocated a €600,000 investment in the Irish Heart Foundation to support two fantastic programmes it runs. In addition, from next year onwards, the GP chronic disease management programme will expand to cover three different areas of cardiology.

It national review is a good review. It is not an implementation plan so we will pull the cardiologists together now and tell them that we will have several million euro of permanent funding and ask what is the best way to begin to deploy it.

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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We cannot compare apples and oranges. My understanding of the review is that it was into acute services, especially primary percutaneous coronary intervention, PPCI, services. It was to look at location and what regions would have full 24-7 PPCI services. There is a separate need for a new cardiovascular strategy that will look at prevention, community care and cardiac care in its totality. As the Minister well knows, the current national cardiac strategy has ceased. It has come to an end, so there is a need for a new strategy. I have been informed by officials in the Minister's Department that they cannot start the work on the new wider strategy until the report into the acute services has been published. As such, it needs to be published. The Minister said that will be "in a few weeks". There is a lot of speculation as to what might happen in the next few weeks. No political party can go out and make promises on any issue unless we have full sight of the independent report into emergency cardiac services. That report needs to be published well in advance of an election. Can the Minister be clearer and firmer about what he means by "the next few weeks"? Will he give an indication of what recommendations the report makes for the south east, in particular University Hospital Waterford?

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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I fully accept the Deputy's point. We will bring the review to Government imminently and it will then be published. The review kicked off after the focus on University Hospital Waterford. That was the genesis of it. I thank Professor Nolan and his team for their work. When the Deputy sees the report he will see it is a comprehensive piece of work. What Professor Nolan and his team have done goes well beyond where 24-7 care should be. They did the work around cardiovascular diseases. As the Deputy will be aware, more than one in four deaths in Ireland is caused by cardiovascular disease. The report Professor Nolan has authored speaks to a lot of issues raised by the Deputy. It looks not only at acute care but also cardiovascular disease across the country. That is why we have put this package together. We have funding for the report, the stroke strategy, the Irish Heart Foundation and GPs as well. That element of this week's budget was intended to say we would apply funding right across the board, be it for GPs, community care, diagnostics or acute care.

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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As I said yesterday, I welcome every single additional cent that is put into any area of healthcare, particularly cardiac services. We will wait to see exactly what funding is being allocated and from where before we pass full judgment on that.

As the Minister stated, the genesis of this review was a meeting with the then Minister for Health, Deputy Simon Harris, attended by me, Deputy Butler, and others. It was to look at whether full 24-7 cardiac care would be provided to Waterford. A second cath lab is in place, and I welcome that. Additional hours of emergency services, extending them from 8 a.m. to 8 p.m. seven days per week, will eventually be provided whenever we get the staff to provide them. I also welcome that. There is still a question mark over whether there is a commitment to full 24-7 cardiac care. The people of the south east and Waterford deserve to know the answer to that question. Is it in the report? Has that been recommended? Is that the position of the Government? I could raise issues about what politicians have said in the past on this issue but I will not do so today. I am only interested in what is in this report for the State and, of course, specifically for Waterford and the south east. Will the Minister give an indication of whether it commits to full 24-7 PPCI services for Waterford and the south east?

10:40 am

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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I will not do the topic justice here. There has been a lot of careful thinking. We will publish the report and allow everybody to look at it in the round. The Government has progressed substantially in terms of the second cath lab in Waterford University Hospital. As the Deputy will be aware, the second cath lab opened in September of last year. That was an important milestone.

The opening hours of the first cath lab were extended the year before that from 8 a.m. to 8 p.m. from Monday to Friday. We are going further than that. Recruitment is now in process for the provision of full staffing to complement the existing services so that the opening hours of the cath lab will be 8 a.m. to 8 p.m., seven days per week.

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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I asked a direct question about 24-7 services.

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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I appreciate that. We will publish the report. Let us all review it in the round.

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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Can the Minister not answer my question?