Matt Shanahan demands 24-7 cardiac care for the South East

Teachta, as you know a number of Sundays ago a man, a gentleman suffered a cardiac event and was resuscitated on the ground outside of University Hospital Waterford. Even if he was inside UHW, a model four hospital in our great republic, he could not access cardiac care as the cat lab was closed as it is 129 hours of every week. Sadly that man passed away two days later in UHW. Where is the 24-7 cardiac care service you promised the South East Taoiseach? You extol your government's capital spending programme, the hundreds of millions you have spent in Cork delivering a new airport runway, two new €100 million teaching blocks to UCC, a new convention centre, the Dun Kettle Interchange. Contrast this treatment to Waterford meanwhile, no capital budget approved for the South East Technological University, a land purchase review now ongoing 14 months to add to the Waterford campus footprint. While UCC is granted a new School of Medicine, we get the deferral to 2026 or beyond of the engineering buildings promised to WIT in 2012. Your government has starved our airport of regional aviation funding. You have threatened the retention of our air sea rescue service. You have offered nothing to address the 20-year-old problems of our South East N24 and N25 road networks. But the obstruction to capital resourcing at University Hospital Waterford offers the greatest insight to the denial of 24-7 for the South East. Kia ora ora, I wish to respect this House's longstanding convention of not making charges against persons here under privilege. But I need to balance that convention against my responsibility to identify the sharp practice over capital and clinical resourcing of UHW by the Cork-based South West Hospital Group. Lies are being told regarding the present strategic development of capital and clinical resourcing at UHW and those responsible must stop or they must be stopped. A recent three-year national heart attack study allied with three years of blue light patient transfer data makes the South East case for 24-7 clinically unassailable. Yet government chooses to ignore this information, preferring to jockey and await the further steered reports required to give it the political answers that it wants, to provide it the political cover that it seeks. Such actions, Taoiseach, reveal an implicit understanding and that is that competition for the private and public, patient streams and indeed student numbers that flow out of the South East region which sustain Cork and Dublin medical and academic privilege must never be threatened, must never be diminished. Your government is abandoning your backbenchers Taoiseach in the South East as you have abandoned your promise to deliver 24-7 cardiac care to the South East region and they will have to answer to the electorate. Without political redirection Taoiseach, I predict the ballot boxes of the South East will bring a heart-stopping arrest to the political careers of many of your government colleagues as well to a number within your own Finnafile party. First of all, Deputy, can I just make one key point to you? You said we were waiting for clinical reviews to get political cover. Actually, anybody who knows anything about how health has evolved over the last 20 years will know that its clinical expertise has been the driver and occasional courageous political decisions in terms of modernising healthcare service in this country. Politics loves to hide behind if you like or likes to ignore the harsh advice that comes from the Royal College of Anesthesia, the Royal College of Surgery, you name it, who set various standards or the authorities in relation to cardiology. So it's wrong to sort of sort it's all politics because no politician wants to close anything in any hospital. I've never actually come across politicians who willingly go to say I want to close that service. The politicians do receive advice of successive parties and successive governments in respect of what's optimal in terms of the safety of patients in a given location. I remember when emergency medical technicians was hardly a profession that was recognised in the country. The most important service for a person who gets a heart attack is the first responder, not how close the hospital is, it's the first responder. And thankfully we have professionalised EMTs through the FEC initiative that we undertook over 20 years ago. And that type of modernisation has resulted in a dramatic reduction in deaths from cardiovascular issues. This country is one of the best in Europe now in terms of survival rates from cardiovascular. And we need to have a debate that's balanced and that's debated with perspective. What we were doing in the past was all wrong in terms of cardiovascular health, in terms of cancer health, and we've changed that over two decades with the result that we're number one in the European Union League table now in terms of lifespan. But we conveniently ignore all of that when it comes to endeavouring to get local political advantage, which I respectfully suggest is probably what you're about. And you summed it up in your last paragraph. When you reduced all this to politics, that someone would pay an electoral price for not going against wholesale advices that have been received from cardiologists and clinicians, whether we like it or not. Now, we have actually, as you know them, you know well, because you've engaged with me on this and you've engaged with other members in this house on this, we have put investment into the cat lab, the second cat lab in Waterford, not just in terms of the facility itself, but the recruitment for the staffing of the new cat lab is ongoing and it will be available, as I said to you before, for use in October 2022. A total of 24 full-time equivalents have been approved by the South-Southwest Hospital Group for the staffing of the second cat lab. And more broadly, in terms of the South-East and generally, employment in the South-East was up 13.6% year-on-year, which is a really strong performance deputy, and you should acknowledge that. And over 120 million in URDF funding was approved by this government to Waterford. 120 million and you come in here and say the government is ignoring Waterford, it doesn't care about Waterford. What you're saying doesn't stack up. Deputy Shanahan. Thanks, John Corley. Teacher, you said I reduced it to politics, I actually didn't. You did when you stood in the grounds of University Hospital Waterford with Deputy Butler and made a commitment to deliver 24-7 cardiac care to the South-East. Secondly, I'd remind you, I brought in data here only the last number of weeks from a three-year National Office of Clinical Audit report, along with three years of patient ambulance transfer times out of University Hospital Waterford that show the average transfer time for a cardiac patient is three and a quarter hours, totally outside of any clinical assessment where they can have any benefit of getting into a cat lab. Beyond that, I'd remind you, I was in the room in 2012 with Ambrose McLaughlin and James Riley when the commitment was given to deliver a second cat lab to University Hospital Waterford and here we are eight years later and we still don't have delivery on it. Beyond that, you talk about the report that's due out and the clinical evidence. There is no clinical evidence. There is evidence now from a three-year, as I said, NOCA report, there's ambulance data and yet you choose to do nothing about it. Presently, in Waterford, what we have now is we have the South-West group running around saying that they're implementing the 24 whole-time equivalent and what have we recruited? One porter, one porter and one cardiac physiologist. That's what we've recruited so far on the promise that was given 18 months ago. So, Taoiseach, it's not about delivery and it's not about politics. I'm here for the people of the South-East and for the people of Waterford. That's who I represent and that's who you should represent and deliver your promise to... But you know that's not the case. I mean, you currently have four whole time approved consultant posts for the existing cat lab. An additional consultant interventional cardiologist post was filled on a permanent basis on the 1st of March and so forth. And look, you know, you're now upping the ante. When I met you some time back, even the commencement of this style, getting that second cat lab in place with staff was all of our collective key priority. That was your priority and everybody's priority here. And that was two and a half years ago. And I accept there are delays in getting the construction and so on. We had Covid and all the rest of it. I can't go down there and build it myself physically, but we have committed the resources to doing it and we've said to the South-West Hospital group and to the HSE to get on with it as fast as they possibly can, both in terms of physical location and in terms of resources. And in terms of, again, the broader situation for water, because I think there needs to be balance. The South-East is progressing and we were very concerned as a government about the economic performance of the South-East to make sure we could improve upon it. And the FDI performance in the region has been strong over the past five years, with employment among IDA clients increasing by 25 percent. And you know about Public Relay, Horizon, Airgen Pharma, Infasis, Tagus, all substantial job. And the Technological University, you know, exchequer funding of 14.3 million to date as we progress that to the Technological University standard, which is a very good thing for Waterford and a very good development for the South-East in general.