Dáil Éireann debate -
Thursday, 7 Mar 2002

Vol. 550 No. 2

Written Answers. - Cardiac Services.

Bernard Allen

Question:

265 Mr. Allen asked the Minister for Health and Children if he will make a statement regarding the cardio vascular health strategy entitled Building Healthier Hearts; and if his attention has been drawn to the view of many groups that the strategy has been slow in starting. [7621/02]

Bernard Allen

Question:

293 Mr. Allen asked the Minister for Health and Children if he will make a statement on the implementation of the cardio vascular strategy. [7796/02]

Minister for Health and Children (Mr. Martin):

I propose to take Questions Nos. 265 and 293 together.

The report of the cardio vascular health strategy group, Building Healthier Hearts, launched by the Taoiseach in July 1999 sets out an excellent blue print for tackling heart disease in Ireland in the long term. The cardio vascular health strategy addresses the common aspects of prevention of all cardio vascular diseases, as well as the detection, treatment and rehabilitation of patients with coronary heart disease. The overall aims identified by the strategy were to reduce the risk factor profile in the general population; detect those at high risk; deal effectively with those who have clinical disease, and ensure the best survival and quality of life.

The rate of premature death from heart disease in Ireland is significantly higher than the EU average. Through the implementation of the strategy, the objective is to reduce Ireland's levels of premature deaths from cardio vascular disease to the EU average in the medium term and a long-term objective is to reduce our rates to those of the best performers in the EU. When the strategy was launched a number of implementation structures were established at national and regional level. These included the heart health task force, the advisory forum on cardio vascular health and regional committees at health board level. Through the prioritisation of the implementation the strategy as advised by the advisory forum on cardio vascular health and work of other groups a co-ordinated, systematic and sustainable approach to its implementation evolved. In the first three years of the strategy €45 million has been allocated to its implementation.

Almost 300 additional posts were filled by the end of 2000 while a further 500 were planned for 2001. These include health promotion officers to provide guidance on smoking cessation, nutrition and physical activity across a range of settings, community and hospital nutritionists, nursing staff in the community and hospitals, technicians essential to the diagnostic service, and cardiac rehabilitation staff including co-ordinators and physiotherapists.

A national media campaign, Ireland needs a Change of Heart, which includes an all island physical activity campaign, get a life, get active and other health promotion campaigns such as NICO, an anti-smoking initiative, were developed and launched.

On 28 February 2001, I announced Government approval for the drafting of a public health and tobacco Bill to give effect to the proposals in the policy document, Towards a Tobacco Free Society.

At regional level a broad range of service developments and initiatives occurred in the areas of smoking cessation, nutrition, physical activity and dissemination of good practice.

In regard to the introduction of nicotine replacement therapy to GMS patients from April 2001 from the launch of nicotine replacement therapy to November 2001, 33,289 prescriptions have been issued to medical card holders at a total cost of €1 million. Discussions on the implementation of the pilot phase of the Programme for the Secondary Prevention of Cardio vascular Disease in General Practice with all stakeholders are now at an advanced stage. It is hoped that agreement will be reached shortly.

At regional level funding has been used for the purchase of training equipment, defibrillators, and ECG transmission equipment and training has been provided for general practitioners and practice nurses and other community based staff on areas such as brief intervention techniques for patient counselling, information technology and life support.

The National Ambulance Advisory Council has been replaced, on a statutory basis, by the Pre-hospital Emergency Care Council. Significant investment in cardiac equipment for use in ambulances has been completed.

In relation to consultant posts, I have received and fully endorsed the interim report from the tripartite group chaired by Comhairle na nOspidéal. I have undertaken as a priority to address a means to begin the process of appointing some of these posts during 2002. In the meantime I am awaiting the final report from this group.

Specific developments included extension of the catheterisation laboratory in Cork University Hospital; a pacemaker service in the South Eastern Health Board region; angioplasty services in the Mid-Western Health Board and provision of diagnostic coronary angiography at Sligo General Hospital on a sessional basis; and chest pain assessment facilities were considerably enhanced in the ERHA region.

All boards have begun developing cardiac rehabilitation in acute hospitals. A national steer ing committee to develop a hospital based heart attack register, Coronary Heart Attack Ireland Register, CHAIR, was established on 14 October 2001. As part of the implementation of the cardiovascular health strategy – Building Healthier Hearts – a pilot project of CHAIR has been set up in the Southern Health Board region. It is envisaged that the pilot will run for one year and following its evaluation a hospital based heart attack register will be established nationally.

Bernard Allen

Question:

266 Mr. Allen asked the Minister for Health and Children if he has sought an explanation from the Southern Health Board regarding the long delay in initiating the pilot project of the coronary heart attack register in the Southern Health Board region. [7622/02]

Minister for Health and Children (Mr. Martin):

The cardio vascular health strategy – Building Healthier Hearts – published in July 1999, recommended the development of a pilot study of a register of heart attack patients. As Minister for Health and Children, I announced the establishment of a national steering committee to develop a hospital based heart attack register – Coronary Heart Attack Ireland Register, CHAIR, on 14 October 2001. The national steering committee under the chairmanship of Dr. Peter Kearney, consultant cardiologist, will have responsibility for the management of the CHAIR project at national level.

A pilot project of CHAIR has been set up in the Southern Health Board region and will involve a phased roll-out of the project in eight hospitals in the region. A local steering committee has been established to oversee the pilot and the Southern Health Board has recently recruited a project manager for the CHAIR project in its region. It is envisaged that the pilot will run for one year and following its evaluation a hospital based heart attack register will be established nationally. Funding of €285,691 has been allocated towards the cost of running the pilot this year.

Discussions have been ongoing with key stakeholders and a software company to develop a suitable database. These are now complete and it is expected that a contract will be signed shortly. It is expected that the commencement of the pilot project will begin in the South Infirmary-Victoria hospital in May 2002.