Ivan Yates
Question:2 Mr. Yates asked the Minister for Health if he will give consideration to arrangements for the referral of public patients awaiting heart surgery for private treatment on a once-off basis, in order to clear the backlog.
Ceisteanna — Questions. Oral Answers. - Heart Surgery Backlog.
There are special circumstances in relation to the recent build up of the waiting list at the Mater Hospital. The decision made by the cardiac surgeons to retain patients at the Mater Hospital for the full duration of the post-operative stay has resulted in a reduction in the number of bypasses being performed and a consequent increase in the number on the waiting list. I have provided special funds for the provision of ten additional cardiac beds to restore activity to the target figure of 750 which was agreed between my Department and the Mater Hospital in 1987. The total costs involved in the project are very considerable: £235,000 for renovation and upgrading, £186,000 for equipment and a £400,000 annual staffing costs. The work is under way and it is hoped that it will be completed by the end of the year.
In view of the success of CABG's which has resulted in an increasing demand worldwide for these procedures which is also reflected in this country, my Department's chief medical officer in consultation with the Irish Cardiac Society is examining the waiting list and other aspects of the service so that an overall strategy can be developed to meet the future demands for cardiac surgery consistent with proper patient care. In that context I am currently investigating the capacity of the public and private systems to reduce the current waiting list.
Is the Minister aware that the number of public patients awaiting cardiac surgery has increased at the National Cardiac Centre from about 300 in January of this year to over 1,000 now? Will the Minister confirm that over 100 people have died who were on these waiting lists? Is the Minister aware of a statement made by an eminent cardiologist who referred patients to cardiac surgeons on this list that some of the patients died because they could not get access to open heart surgery? Does the Minister not have any sense of responsibility to those patients and to their families?
In this instance the reason for the reduction in the number of procedures performed at the Mater was the unilateral decision of the consultants after the allocation of money. Quite a substantial increase was made to the Mater Hospital and they decided they would retain the patients for the full ten days' post-operative stay rather than five days as formerly. That resulted in a reduction in the number of procedures they were able to perform. That was their decision. I do not dispute their right to make that decision. It was a clinical decision and I respect it as such, but that was done without any reference to my Department. When we discussed that with the hospital we agreed to restore their capacity to 750 procedures per annum and we provided the funding for that.
I do not accept the Deputy's point that the waiting list is over 1,000. I accept that there is a substantial waiting list, but it is a very dangerous exercise for Deputy Yates to come in here and play God in relation to people dying. People on waiting lists die, unfortunately. People on waiting lists have always died. Indeed, one of the cases Deputy Yates referred to where a consultant cardiologist said that a patient on the waiting list had died, was a person who had been on the waiting list only a couple of months. That patient was not waiting a long time for the procedure and it is hypocritical of any Deputy whose party was in Government——
We should not have a sermon from the Minister.
(Interruptions.)
——to come in here and say that there was no waiting list when they were in Government. There was a waiting list when I came into Government.
Deputy Allen must not intervene.
The Minister should not be giving a sermon.
If the Deputy persists I shall have to ask him to leave the House. The questions, in this instance, are confined to the Deputy in possession, Deputy Ivan Yates.
Is the Minister aware that there is a cardiac committee where the consultants have made known their view that they were not prepared to discharge their patients after four days, that some of those patients had had serious relapses and that the patients were threatening litigation against the consultants whose legal responsibility it is to discharge those patients? Is the Minister further aware that the surgeons had no other choice but to keep those patients in hospital for the full ten days and that the real problem was that there were only 25 beds in the Mater centre? Will the Minister now address the question he was asked: in order to avoid a further loss of life, will the Minister make arrangements through the medical officer of his Department to ensure that those most urgent cases who cannot be treated under the two operations per day rule, will be treated in private hospitals on a tender basis, on a once off system, to ensure that further lives are not lost.
The question is becoming unduly long. We are on priority questions.
The Ceann Comhairle disallowed two of my questions and we have ample time to deal with this, my most important question.
Please conserve the precious time left to us.
It is a matter of life and death for those people. Would the Minister consider referring these patients privately? The cost per treatment is £5,000 or £6,000. In view of the report he received from his medical officer, will he take such urgent action?
I respect the consultants' decision and I understand why they made their decision. It was a clinical decision and I have no quarrel with it. What I quarrel with is that the first we knew about it was when we read it in the newspapers. No one came to the Department and said they needed funding as a result of this change in their practice. We are looking at all options in conjunction with the Irish Cardiac Society. To an extent we are victims of our own success.
Since I became Minister we have installed some of the most sophisticated cardiac investigative equipment in the world. We spent £10 million in St. James's Hospital and as a result more sophisticated investigations can be carried out on patients and more people are coming on the waiting list. We recognise our responsibility and are looking at how we will provide for patients. In Cork there is a cardiograph unit with only one consultant and it is my intention to rectify that as a matter of urgency. As regards the short term problem, I agree with Deputy Yates that we must see if it can be done more economically and rapidly through the private system.
A final question.
Question No. 3.
I will only ask——
Do not try to defy the Chair. The time for priority questions is running out.
I will ask one supplementary.
I have called the next question.
One final supplementary, please.
No. The Chair will be obeyed.
In view of the fact——
Question No. 3 has been called and will be heard.
This is most regrettable.
Please desist. We have devoted a lot of time on two questions.
This is a vital matter. In view of the fact that Ireland has the fourth highest rate of heart disease in the world——
Question No. 3.
——will the Minister ensure that adequate beds will be available for open heart surgery?
The Deputy is penalising himself.