Limerick East): Admission for open heart surgery in the public hospital service is determined having regard to the medical condition of patients, not on the basis of whether they are classified as public or private patients or whether they have medical cards. Admission is based solely on the patient's condition and not on the length of time on the waiting list. Emergency cases are given priority. In these circumstances, the average waiting time is not a critical indicator of the adequacy of the service available. Accordingly, I am satisfied that within the public hospital service access to the service is determined by medical need.