Vol. 481 No. 3
5 Mr. Shatter asked the Minister for Health and Children when he will make a decision in relation to the location of the required new cardiac unit; and the reason for his reviewing the decision made by his predecessor that it be located at St James's Hospital, Dublin 8. [15973/97]
At present cardiac surgery is provided at two centres, the Mater Hospital and Cork University Hospital. From the latest information available to me, the total number of patients awaiting cardiac surgery stands at 1,598.
The provision of additional cardiac surgery facilities is a matter of urgent national importance and one which will require significant capital and revenue investment in the next few years. The policy decision to locate a third cardiac surgery unit at St. James's Hospital was based on the recommendations of the cardiac surgery option appraisal group and was announced a matter of days before my appointment as Minister.
On taking office, I undertook to examine the report of the cardiac surgery option appraisal group to satisfy myself in relation to the policy basis for this major service development. The question of the provision of cardiac care services overall is under review. An announcement will be made on the location of additional cardiac care services when this review is complete.
A sum of £1.6 million is being made available under the 1997 waiting list initiative specifically for cardiac patients, adults and children. As in 1996, the main aim is to reduce the existing national cardiac surgery lists. The Department's strategy for achieving this aim involves the purchase of additional cardiac procedures and the selection of suitable patients for medical cardiac therapies. High standards of evaluation and audit will be applied to the initiative. Participating agencies will be required to demonstrate clearly how the additional activity has impacted upon existing waiting lists and a full report will be required from each hospital on the matter.
Does the Minister accept that the report of the appraisal group categorically recommended that St. James's Hospital be the location of the new cardiac unit? Will he not acknowledge that the decision made by the previous Government to establish the unit in St. James's was based on an objective study of the options available; and will he accept that while he dithers on the issue, patients may die?
The Cardiac Surgery Option Appraisal Group did recommend that the unit be located in St. James's Hospital. However, I am seeking to formulate a national cardiac care policy similar to the cancer strategy adopted by my predecessor in relation to the other big killer disease. I have taken it upon myself to study that report and consult the hospitals involved. That review is almost complete and I will be making a decision shortly on the matter to ensure that we have sufficient and adequate numbers of prospective operations to deal with the existing backlog.
Is the Minister seriously suggesting that he personally has a greater expertise than the people who comprised the appraisal group? There is currently an average waiting time of two to three years for cardiac surgery in the Mater Hospital which, as of today, has 1,459 people on the waiting list and an average waiting time of 12 months in cardiology for angiograms and angioplasty with over 830 people on that waiting list. Therefore, will the Minister acknowledge that it is indefensible to cancel a decision made by the previous Government and to delay the processing and the construction of this unit by a period of five months for party-political reasons, and still not be able to tell the House that he is proceeding to provide this unit in St. James's Hospital?
I reject the Deputy's contention that party politics are involved. I am trying to ensure that a proper cardiac service will be available to everybody, regardless of their location. The waiting lists are not simply in one health board area but in a number of health board areas. We want to make sure that a national cardiac care strategy will deal with the issue for everybody.
Is the Minister saying the appraisal group was wrong in its recommendations?
The appraisal group has come down in favour of St. James's Hospital in relation to 500 procedures. I am looking at the possibility that we may need more than 500 to start dealing efficiently and expeditiously with the current backlog. I want to look at all options and facilities that are available here to make that happen.
There is an onus on the Minister, when he has rejected the appraisal group's recommendations to give us a single good reason for doing so. The Minister is well aware there is a feeling abroad that the constituency interests of his Minister of State seem to weigh more heavily with him in this matter than the needs of people who are on a waiting list for cardiac surgery.
I am not rejecting the review group's proposals or options. I am simply reviewing them to ensure that all parts of the country are evaluated. If the Deputy is suggesting that this should not be a consideration for a Minister, I have to disagree with him. I am evaluating the situation on a national basis to make sure that the waiting lists in all areas are properly dealt with and that if more than one site is required we will go ahead and provide more than one. That review is almost complete.
In examining all the options available for a cardiac unit, has it occurred to the Minister to consider the possibility of an arrangement with Northern Ireland to facilitate patients who have been a long time on a waiting list, particularly people who live in the northern part of the country, and especially Donegal?
Deputy McGinley is making my case. There are other parts of the country where there are concerns about the availability of these facilities. I wish to make sure that all parts of the country are properly evaluated, that suggestions, including the one put forward by Deputy McGinley, are properly considered, and that we make decisions for all parts of the country.
Is the Minister saying that the appraisal group did not consider this issue on a national basis? Will he not acknowledge that the appraisal group considered all the available options in the context of the national need, not simply the need within the Eastern Health Board area? Will he now acknowledge, having considered the appraisal group's report for a period of five months, that his accusation that the decision of his predecessor, Deputy Michael Noonan, to make St. James's Hospital the site of the extra cardiac unit was a politically motivated decision was incorrect and that it was a decision to implement the objective recommendation of the appraisal group? Will the Minister not acknowledge that if he is considering providing additional capacity beyond the 500 unit proposal of the appraisal group, and if he is considering providing it elsewhere in the country, there is no reason he cannot sanction the St. James's Hospital development and at a future date sanction any further proposal that he deems appropriate? What he has effectively done is to put this issue in limbo and the construction of this unit on hold unnecessarily to the detriment of the health service and to the detriment of those who require cardiac surgery.
The appraisal group has done good work and I have no problem with it. Let me reiterate that I am making sure all parts of the country are considered and that we make a decision which is fair to everyone.
Did the appraisal group not consider all parts of the country?
In relation to whether I can succeed in getting more than 500 units, I want to make sure that we go ahead on a basis that is fair to all parts of the country.
The Minister is playing constituency politics with matters of life and death.
I reject that with the contempt it deserves.
