Written Answers. - Cardiac Group Report.
Paul Connaughton
Ceist:
28
Mr. Connaughton
asked the
Minister for Health and Children
the reason for the delay in announcing the steps proposed by him to implement the cardiac appraisal group's report and in the provision for further additional resources required to meet the needs for cardiac surgery and cardiology to reduce the waiting lists in this area.
[2188/98]
Emmet Stagg
Ceist:
53
Mr. Stagg
asked the
Minister for Health and Children
the recommendations of the cardiac surgery appraisal group; the status of and his intentions in relation to this issue; and if he will make a statement on the matter.
[2141/98]
Eamon Gilmore
Ceist:
76
Mr. Gilmore
asked the
Minister for Health and Children
if the review in relation to the recommendations of the cardiac surgery option appraisal group that the new cardiac surgery unit should be located in St James's Hospital, Dublin 8, has been completed to date; if the recommendation of the appraisal group will be implemented; and if he will make a statement on the matter.
[2134/98]
Dinny McGinley
Ceist:
88
Mr. McGinley
asked the
Minister for Health and Children
the reason for the delay in announcing the steps proposed by him to implement the cardiac appraisal group's report and in the provision for further additional resources required to meet the needs for cardiac surgery and cardiology to reduce the waiting lists in this area.
[2189/98]
Bernard J. Durkan
Ceist:
138
Mr. Durkan
asked the
Minister for Health and Children
the total number of persons currently on the waiting list for cardio by-pass surgery; the average waiting time for such patients seeking attention under the public health programme; the action, if any, he has to improve the situation; and if he will make a statement on the matter.
[2321/98]
Alan Shatter
Ceist:
151
Mr. Shatter
asked the
Minister for Health and Children
the reason for his ongoing delay in announcing the steps proposed by him to implement the cardiac appraisal group's report and the provision for the further additional resources required to meet the needs for cardiac surgery and cardiology to reduce the waiting lists in this area.
[2343/98]
I propose to take Questions Nos. 28, 53, 76, 88, 138 and 151 together.
On taking office, I gave a personal commitment to review the recommendations of the cardiac surgery option appraisal group. Today, after a little more than six months in office, I was pleased to announce today a comprehensive package of proposals aimed at reducing mortality from cardiovascular disease.
Cardiovascular disease, the term used to describe the associated diseases of the heart and circulatory system, is a major cause of premature mortality — persons under 65 — in Ireland, accounting for almost one-third of all premature deaths. In 1996, 1,787 Irish people under 65 died from cardiovascular disease. The mortality rate from ischaemic heart disease in the under 65 age group is approximately twice the EU average. In addition to those who die prematurely from cardiovascular disease, many others suffer ill-health and a reduction in their quality of life.
The information available to me on the incidence of heart disease and demographic trends suggests that cardiovascular disease will continue to present a major challenge in the years ahead. It is clear that if the target of the health strategy to reduce the death rate from cardiovascular disease in the under 65 age group by 30 per cent before 2005 is to be achieved, an integrated approach to the prevention and treatment of the disease is an absolute requirement. The development of a strategy for cardiovascular health is central to the achievement of this target. Investment in cardiac treatment must be matched by an equivalent investment in improved prevention and primary care facilities.
To tackle this major public health problem, I have announced today a comprehensive package of proposals aimed at achieving such an integrated approach to the prevention and treatment of cardiovascular disease. The proposals are built around three key initiatives as follows: the establishment of a national strategy to improve cardiovascular health; the provision of additional public cardiac surgery facilities for adults and children to tackle the large backlog of approximately 1,650 patients awaiting surgery and to guarantee public hospital patients access to cardiac surgery within an average waiting period of six months of being placed on the waiting list, and the development of a heart/lung transplant programme for patients with cystic fibrosis and other lung diseases in the medium term.
Before I outline the details of the above proposals which I mentioned, I would like to commend the Mater Hospital for its sterling work over the years as the national cardiac unit and I would like to confirm that it will maintain its position as the national cardiac surgery unit and a centre of excellence for cardiovascular surgery. It will retain its responsibility for treating the most complex surgical cases, including transplants and congenital heart conditions. In line with this, it will be encouraged and supported in playing a more active leadership role in the ongoing organisation and development of all aspects of cardiac surgery care at the other centres throughout the country.
I intend to appoint a cardiac health strategy group which will develop an integrated strategy on cardiovascular health by the middle of 1998. The membership of the group will include a cardiologist, a GP and a public health specialist. The strategy is expected to cover preventive medical, surgical and rehabilitation services, health promotion and education initiatives to tackle risk factors, organisation and evaluation of services and ongoing research into the causes and treatment of cardiovascular disease.
As Minister for Health and Children, my priority is to address the existing cardiac surgery waiting lists and the overriding objective is to achieve an average six month waiting period for those on the lists. From the latest information available, there were 1586 patients — adults and children — on the public cardiac surgery waiting list at the end of September 1997; 1,237 of these patients were awaiting by-pass surgery and the average waiting time for this procedure is two years.
I am confident that the development of additional adult public cardiac surgery facilities at St. James's Hospital, Dublin, and University College Hospital, Galway, will help reduce the unacceptable waiting lists which exist at present. Target activity levels would be in the region of 450 procedures annually at St. James's Hospital and 300 procedures at UCHG. This additional activity will increase existing adult public cardiac surgery capacity by over 50 per cent. In addition, I intend to put in place additional cardiology facilities at Cork University Hospital to augment the existing cardiac facilities there.
The current situation whereby 70 per cent of children awaiting cardiac surgery have been waiting for longer than six months is unacceptable. Consequently, I am proposing to develop additional children's cardiac surgery capacity at Our Lady's Hospital for Sick Children, Crumlin, in association with the national cardiac unit, Mater Hospital, to provide for up to an additional 100 cardiac procedures for children. This additional activity will increase existing paediatric cardiac surgery capacity by up to 40 per cent.
Finally, I propose to implement the Government's commitment to develop a heart and lung transplant service on a phased basis as follows: (i) by working to secure the best possible access to existing facilities in the UK for Irish patients. Alongside this, we will be improving the pre-operative and post-operative support for transplant candidates and also helping to ease the burden on those who have to travel abroad for surgery, as well as their carers; (ii) the establishment of a formal "mentor" link between a centre of excellence abroad and the Irish hospitals who will care for heart/lung transplant patients. The Mater Hospital, with its expertise in heart transplantion, will be the designated surgical site for the heart/lung transplant programme in association with other key service providers, in particular St. Vincent's Hospital, Elm Park, which is currently the national centre for cystic fibrosis; and (iii) It is proposed to commence lung and heart/lung transplant surgery as soon as the skills and resources in this country can offer a transplant programme which guarantees results which are at a minimum on a par with those achieved internationally.
I am confident that the proposals which I have announced today will help to tackle the huge problem of cardiovascular disease in this country and specifically the issue of premature death from the disease.
