Paudie Coffey (Fine Gael) | Oireachtas source

I welcome the Minister of State, Deputy Marcella Corcoran Kennedy. The Minister for Health, Deputy Simon Harris, is only too well aware of the significant issue I wish to raise.

Access to cardiac intervention is a critical need where a citizen has a heart attack. Unfortunately, in the Ireland of 2016, we do not have equality of access to health care in the event of an emergency. That is particularly the case in the south east. The essential target response time to achieve the best cardiac intervention outcomes in the event of a heart attack is 60 to 90 minutes. The south-east region, however, has only one catheter lab which operates at University Hospital Waterford between the hours of 9 a.m. and 5 p.m. five days per week. The south east is , therefore, the only region in the country which does not have access to 24/7 interventional cardiac care within the critical period to which I referred. No intervention is available after hours, which means lives are being put at risk. This issue has been highlighted consistently by myself and others in recent years.It is important that we examine the context and background to this issue. In 2012, Professor John Higgins was appointed by the Government to take an objective, independent view and to make recommendations to Government on the reform of the hospital systems in the South and in the country. His findings are otherwise known as the Higgins report.

In 2013, there was reform of the acute hospital network and the establishment of hospital groups. It resulted in the break up of the old South Eastern Hospital Group that transformed what was then the Waterford Regional Hospital into the University Hospital Waterford. At that time, clear commitments were given to the public, politicians and clinicians by the former Minister for Health, Senator Reilly, and the former Secretary General for the Department of Health, Dr. Ambrose McLoughlin. The commitments included an enhancement of interventional cardiology at University Hospital Waterford. The records are available for anybody to see in the Department of Health and I urge the Minister of State to make herself aware of them. Three years later, the hospital boards have still not been appointed and commitments have not been met. This is a serious breach of trust in the reform programme in terms of the public, politicians and health professionals.

In terms of the recent Herity report, three areas require specific focus and attention. First, the base population and throughput data that was used in the report is fundamentally flawed because it took into account the current patient throughput of a part-time service. It also did not take into account the potential patient referrals in a region of 500,000 people if a 24 hours, seven days a week service was available.

Second, Dr. Herity has stated that it is possible to travel from Waterford to the University Hospital Cork within a 90 minutes' timeframe. That is incorrect in terms of many of the outlying areas of Waterford, including south Wexford, south Tipperary, east Waterford and south Kilkenny. His timeframe does not take into account the transfer times for patients from outlying areas, who are in urgent need of intervention, going to Waterford in the first instance. Dr. Herity acknowledged in his report that there is no stated alternative to get patients outside the 90 minute zone to cardiac care. The only way to do so, and logical people would agree with me, is through the provision of an air ambulance, a measure that is not possible in the current climate. Therefore, lives in the south east are at risk in the event of an emergency.

Third, I am seriously concerned about the fact that the Department of Health gave a note to Dr. Herity prior to him compiling his report. That gives the impression, whether it is right or wrong, that Dr. Herity was guided by the Department officials and, thus, his report was pre-determined. The situation raises questions about the independence of his report and is a matter that needs further analysis and examination. In my opinion, the basic flaws in his report undermines its findings and recommendations. Alternative findings have been proposed to the Minister and we ask him to consider them. It is essential that the three aspects of the report that I have identified be reviewed before decisions are made about the future of the cardiology services in the south-east region.