I thank the Ceann Comhairle for allowing me to raise on the Adjournment the extraordinary loose, unChristian and uninformed remarks made by the Minister for Health in the Dáil Chamber on 26 March 1992.
The Minister has a reputation for sometimes talking before he thinks, an unfortunate practice for one in charge of an area as sensitive as the health services. To say that artery by-pass operations have become very fashionable, that a person's life cannot be lengthened by an operation any more than it can be lengthened by taking tablets prescribed for the condition, that he would defy any consultant cardiologist to contradict what he was saying and that an operation may improve the quality of life but the same results can be achieved with tablets, defies the imagination. He also said it was an acceptable fact that hi-tech ultramodern medicine gobbles up huge financial resources of the health budget and these resources may be better utilised in the primary care area of medicine, education or the environmental needs of the country.
I take no pleasure in castigating or contradicting a fellow medical practitioner. I take no pleasure at all in questioning the veracity of the Minister's statements. There are five effective methods for the treatment of coronary artery disease which has progressed to the stage where it causes symptoms. These are as follows: (1) the adoption of a healthy lifestyle; (2) the treatment of pre-disposed conditions, such as high blood pressure or high blood fats; (3) drug treatment; (4) angioplasty and (5) coronary artery by-pass graft, or CABGs, as the Minister referred to them. The first two procedures are employed on all patients for whom they are relevant. Drug treatment is used by every family doctor. The vast majority of patients referred to cardiologists have already been on drug treatment which has failed to relieve their symptoms. It is because of this failure that these unfortunate patients are referred to cardiologists and cardiac surgeons for assessment.
Coronary artery surgery was introduced in Ireland in 1967. The indications for this procedure are well recognised and documented. Assessment will discover whether a patient has extensive coronary artery disease which, if not corrected, may lead to the person suffering a heart attack or, even worse, dying suddenly. Angioplasty dilates the arteries with a balloon and does not require an operation. In cases where it is deemed to be a safe and potentially effective alternative it is used as the intervention of first choice.
Coronary artery surgery candidates fall into clearly defined groups: the unfortunate patient with angina at rest; the pre-coronary syndrome patient; the post-coronary patient with blocked arteries and, most dramatic of all, the patient who is discovered to have his left anterior descending coronary artery seriously blocked — the so-called widow-maker — who will almost certainly die suddenly if he does not have this operation. That is a well documented medical fact.
I wish to point out to the Minister that the anguish, pain, worry and mental torture he has caused to patients who have had the operation, patients who have had a stormy recovery period after an operation, the families of patients who tragically have not recovered from the operation and people on the waiting list for the operation is incalculable. It is unbecoming for a person in the Minister's position to make the kind of unfounded statements he made in regard to the operation. When taken in the context of the Minister's previous gaffe when he suggested that consultants should contribute £5 million of their back pay award to the mentally handicapped services, forgetting that the Government will take in £7 million in income tax, his statement defies imagination. To say that this operation is fashionable is not only damaging to patients who have undergone or who are awaiting surgery but casts a slur on the integrity, ethics and professional competence of cardiac surgeons, cardiologists and anaesthologists.
