Thank you very much indeed, a Cheann Comhairle, for giving me the opportunity to raise this very important health issue. I do not often raise matters on the Adjournment but this is a matter of very deep concern to me.
I tabled a Dáil question last week about the total number awaiting cardiac surgery nationally and I was told that the number on the waiting list as of the end of April was 743. I am afraid that statistic does not detail the type of difficulties I have come across through individual patients, and when I pursued this with the medical personnel and the hospital authorities I was quite shocked to hear the current state of events.
I am advised that some patients have to wait up to three and four years for heart surgery. These patients are called elective patients and are placed on a waiting list. We have a national cardiac centre at the Mater Hospital. It does most of the public patients in Dublin. The others are done in Cork Regional Hospital and the children are done in Crumlin. The waiting list in Crumlin is over 600. The precise difficulty is that last December the number of heart surgery operations was reduced from three cases per day to two cases per day. This was because prior to December patients were being discharged from the Mater Hospital to their referring hospital after three to four days. However, in some cases the health of the patient relapsed while in other cases litigation was threatened by patients and their families because of the shortness of their stay.
It is generally accepted by cardiologists and cardiac surgeons that the normal recuperating period is ten or 11 days in the intensive care unit of a cardiac hospital. The consultants decided, and quite rightly, that they could not leave themselves open to litigation by discharging those patients after three to four days. They insisted that they would have to reduce the number of operations from three to two and allow patients to stay ten to 12 days in the Mater Hospital. The problem is that there are only 25 beds in the cardiac unit of that hospital. Therefore, if people stay longer in those beds after their operation, fewer operations will be carried out. This has meant that a bad situation has become chaotic.
I have been advised by a variety of medical personnel that patients on the waiting list have died and that the lives of those on the waiting list are at risk because of the delay and the limited access to cardiac surgery. We have reached a critical stage and I understand that the position is deteriorating weekly. No impact can be made on the waiting list. The minimum number of additional beds required to stop the problem getting worse is ten beds bringing the number to 35. Four consultant cardiac surgeons operate out of that unit and they have six beds each. Their position has been made impossible. Some of them share appointments with St. James's Hospital and with Our Lady's Hospital in Crumlin. We are all aware of the problem highlighted last week in regard to a quintuplet who was due to have a heart operation on a Sunday but the surgeon stated that he could only perform the operation on a Friday. The delay was critical but, fortunately, all is well. The surgeons have advised me that however bad the situation is in Crumlin and it is bad, it is a lot worse in the Mater Hospital, the national cardiac centre.
Even if the 35 beds were approved the number of operations annually would rise to 750 compared with 1,000 per annum four years ago. If the Minister responds by allocating an extra ten beds it will be short of what is required. We should remember that we have the highest mortality rate among those 50 years of age in OECD countries and that we have one of the lowest life expectancies. According to international statistics one out of two people here die from heart related diseases. About 2,500 adults require heart surgery each year here and if we allow for 750 operations in the Mater Hospital — they will carry out fewer operations this year; 500 in private hospitals; almost 200 in the regional hospitals and 150 in Our Lady's Hospital in Crumlin that means that we will be 1,000 operations short of the requirement.
It should be remembered that in the Mater Hospital surgeons work under primeval conditions. I have been advised by medical, and other health services personnel working in the hospital, that because there are only 25 beds, incoming patients must queue up in corridors until patients are discharged. That is unacceptable. I have also been advised that when transplant operations take place two or three beds are taken up in one room leading to further difficulties on the waiting list. That is unacceptable but the staff have had to work under those conditions for a number of years. The bottom line in terms of the treatment of patients is that if one of the 600 on the waiting list is told by the consultant that there are more urgent cases ahead of him and that it will not be possible to treat him that patient is advised by the hospital authorities that if he becomes seriously ill, gets a relapse, a stroke or a heart attack he should contact his local general practitioner. That is unacceptable, particularly when we are dealing with people at risk.
My information is that the consultants with six beds each can only deal with emergency cases, patients rushed in by ambulances. As a result those on the waiting list are being moved further away from treatment. I have been patient since the House held a debate on a motion of no confidence in the Minister for Health some months ago and I was waiting for reports of committees under Mr. Fox and Mr. Kennedy but I cannot allow this drift any further. I saw reports in the Medical News and the Irish Medical Times as far back as last January that the matter would be dealt with shortly but I was advised no later than to day that the problem is getting worse. I regret that the Minister is not present to give us his views on this matter and I should like to ask the Minister of State to give a commitment that within a matter of days an extra ten beds will be made available. The Department should make adequate long-term provision for the speciality of cardiac surgery. They should ensure that patients who cannot afford to go to Blackrock Clinic at a moment's notice and do not have access to private health care because they cannot afford to be in the VHI, are protected. This is unacceptable and I am seeking an immediate response from the Minister of State.
