Máirín Quill
Question:8 Miss Quill asked the Minister for Health the number of people on the waiting list for cardiac surgery in the Mater Hospital, Dublin, and in Cork Regional Hospital.
Ceisteanna—Questions. Oral Answers. - Cardiac Surgery Waiting List.
Helen Keogh
Question:14 Ms Keogh asked the Minister for Health the longest period a person has been on the waiting list for cardiac surgery.
Helen Keogh
Question:99 Ms Keogh asked the Minister for Health the number of people who died while on the waiting list for cardiac surgery in each of the last five years.
I propose to take Questions Nos. 8, 14 and 99 together.
There are a total of 1,436 patients on the waiting list for cardiac surgery in the Mater Hospital and 62 awaiting cardiac surgery at Cork Regional Hospital.
I understand from the Mater Hospital that there is a patient on their waiting list since July 1987. However, the admission of a patient to hospital for cardiac surgery is a clinical decision taken by the consultant concerned, based solely on the patient's condition and not on the length of time on the waiting list. Emergency cases are given priority.
The number of people who die while on hospital waiting lists is not routinely collected by my Department or by hospitals. The Deputy will appreciate that the death of a person may not be related in any way to the condition for which the patient has been listed for treatment.
Since coming into office, some 14 months ago I have been concerned to ensure the expansion of existing facilities for cardiac surgery in the public hospital sector. In 1993, I allocated an additional £1 million from the waiting list fund to improve the capacity of the National Cardiac Surgery Unit at the Mater Hospital. An additional sum in excess of £2 million has been allocated to the Mater Hospital for cardiac surgery and related developments for 1994. I am very conscious of the need to provide additional coronary artery by-pass graft — CABG — procedures. This injection of funds will bring the annual output at the Mater Hospital of CABGs up to 1,000 per year.
This major programme of refurbishment at the National Cardiac Surgical Centre at the Mater Hospital has been ongoing since the middle of last year and is now nearing completion. The development includes additional cardiac maintenance beds, intensive care facilities and high-dependency facilities which are required to support the cardiac surgery programme, including heart transplantation.
This injection of extra resources will enable additional staff to be recruited and extra medical equipment to be put in place so that these facilities can function to their required potential.
A £2 million capital development at Cork Regional Hospital, consisting of an additional cardiac theatre and extra intensive cardiac care facilities, is due for completion in August 1994. The coming on stream of this development, together with the developments in progress at the National Cardiac Centre at the Mater Hospital, will have the effect of increasing the capacity for heart by-passes to be performed on an annual basis in the public hospital sector by a factor of 47 per cent.
I am glad the Minister is aware of the problem. It is not satisfactory, no matter on what ground that somebody should have been on the waiting list since 1987. This is simply appalling and reflects very badly on our overall medical services. Would the Minister agree that this should not happen? Would he agree that the need for cardiac surgery will continue to grow substantially and that, while he has allocated funds, they will not be sufficient to meet the growth in demand for cardiac surgery in ensuing years? Has the Minister a plan in place which will take us to the stage at which a person will be able to have cardiac surgery within a maximum of 12 months of being diagnosed?
Certainly I would agree that a waiting time of the order indicated is not satisfactory. I do not know the circumstances of the case, the conditions, whether the person was suitable for surgery at any given time, or whether there was need to wait. I said almost from the moment I became Minister that I was not happy with the level of capacity for heart surgery. That is why I set about immediately providing very significant additional resources which will have the effect of increasing the throughput at the Mater Hospital from 750 cases to 1,000 cases annually and that at the Cork Regional Hospital from 200 cases to 400 cases, a doubling of the Cork hospitals capacity and a 30 per cent increase in the Dublin capacity. I believe that the 1,400-case capacity which will be in place by the middle of this year — obviously involving a lot of capital works — is sufficient to meet what is now the annual figure. In theory, nobody should have to wait longer than 12 months for such surgery. Obviously I am aware that there may be an increased demand for this facility — that is something we really cannot envisage. It might be necessary to re-examine in the future either the extension of those facilities or the creation of new facilities elsewhere in the country.
Before posing my question, I should like to pay tribute to the consultant at the Cork Regional Hospital who is working there alone. Everything ceases when he is either ill or on holiday. Has the Minister plans to appoint a second cardiothoracic surgeon to Cork Regional Hospital? There is no point in providing facilities unless a second consultant is appointed.
I am pleased to inform the Deputy and the House that I have approved the appointment of a second cardiac surgeon for Cork.
Would the Minister accept that the need for cardiac surgery is a very daunting and worrying one for the families of patients? In those circumstances, would he not agree that it would be wise to identify patients who are ready for such surgery, so designated by their consultants, in order to eliminate those who may not be capable of surgery at present, thus identifying the actual list of people waiting and deal with them?
The Deputy has raised a very important issue, which is the whole validation of waiting lists. One of the positive effects of the initiative on the waiting list last year was that we had the capacity to address very significant volumes of work and re-evaluate waiting lists. We discovered there were people on waiting lists who, in some instances, had not been appropriately placed. I am not suggesting that that is the case of the waiting list for cardiac surgery. There is constant need for evaluation and validation of waiting lists. The only way is to have a sufficient capacity available so that nobody can be expected to wait an inordinately long period of time. That is my objective. Other important factors I should mention are the causes of cardiovascular disease, the promotion of a healthy lifestyle, nutritional programmes and exercise, in particular campaigns against smoking, including the one I launched on Ash Wednesday. These are extremely important in reduing the demand for this type of surgery.