Written Answers. - Combined Surgical Procedures.

Bernard J. Durkan

Question:

642 Mr. Durkan asked the Minister for Health and Children the position in relation to the provision of surgical facilities required by cystic fibrosis patients with particular reference to combined surgical procedures; and if he will make a statement on the matter. [2202/99]

I am assuming when the Deputy refers to combined surgical procedures that he is talking about patients requiring a heart and lung transplant as against a lung transplant. I am advised by clinicians at the adult cystic fibrosis unit at St. Vincent's Hospital that since cystic fibrosis patients requiring transplant have mainly a loss of lung function, the tendency now is towards double lung transplantation rather than the more extensive heart and lung transplant. In many cases this is proving to be more effective both in terms of survival rates and better utilisation of donor organs, in that heart-lung blocks donated can now be used by more than one recipient.

The Deputy will be aware that the programme for Government, An Action Programme for the Millennium, contains a specific commitment to support the establishment of a heart and lung transplant facility in Ireland. At present Irish patients requiring this service travel to the UK. In terms of advancing the arrangements necessary to establish an Irish based programme, the Mater Hospital has been designated as the surgical site in Ireland for heart and lung transplants. The Mater Hospital will provide this service, in association with other key service providers, in particular St. Vincent's Hospital, Elm Park which is the major centre for the treatment of adult cystic fibrosis.
The Mater Hospital, as a matter of urgency, is co-ordinating and finalising a detailed assessment of the infrastructural and service issues involved in developing the programme in Ireland including the training needs of the staff at the unit. I can assure the Deputy that I am committed to providing the necessary finance and support for the development of a quality transplant programme in Ireland at the earliest date.
Of more immediate concern to patients awaiting a transplant in the UK is whether the existing level of service can be improved in any way while an Irish based programme is being established. Detailed discussions have been held with four UK centres with a view to establishing a contractual arrangement with one of the centres for the treatment of Irish patients. Intensive negotiations with one of these centres are now under way and I am confident that a contract will be finalised in the coming weeks which will result in a significant improvement in the exisiting service. One of the improvements which I intend to put in place is the introduction of an Irish based assessment clinic for patients in order to ease the burden on patients and their families who at present require to travel to the UK for assessment.