(Limerick East): As Deputies are aware, there is no facility for lung or heart-lung transplantation in Ireland. It has been estimated that the annual lung and heart-lung transplant caseload would be 20 transplants approximately, if a programme could be commenced. Patients in need of these operations are referred by their consultants for assessment to any of three centres in the United Kingdom — Newcastle, Harefield and Cambridge — with a view to being put on a waiting list for a transplant. Figures to the end of 1996 indicate that in the region of 30-35 Irish patients are awaiting transplants in the United Kingdom. There is no formal agreement with the United Kingdom hospitals. Public patients are approved for travel by their local health board. I am aware of the difficulties being experienced by patients in having to travel to the United Kingdom but the caseload is small and it is difficult to build expertise.
The Department requested the Mater Hospital to prepare proposals concerning the feasibility of establishing a heart-lung transplant programme. We are listening to advice but there are a number of problems, including the cost involved, the small number of patients who require transplants and the consequent problem of building expertise in this area. Unless there is sufficient throughput, the consultants involved do not have sufficient cases to build expertise to the desired level. Other issues also arise.
Taking into account the experience gained in establishing the liver transplant programme, we should be able to make some progress along the lines suggested by the Deputy. Many patients travel to Harefield. I envisage Irish consultants travelling to a United Kingdom hospital on a term basis to build expertise and applying the skills learned here. No decision has been made as to the location. This is being explored by consultants at the Mater Hospital.