Tuesday, 5 February 2019

Ceisteanna (48)

Marc MacSharry


48. Deputy Marc MacSharry asked the Minister for Health when a permanent cath lab will be located at Sligo University Hospital; and if he will make a statement on the matter. [5400/19]

Amharc ar fhreagra

Freagraí ó Béal (10 píosaí cainte) (Ceist ar Health)

Against the backdrop of the overruns in the cost of the children's hospital, there is considerable concern about the provision of a cardiac catheterisation laboratory facility at Sligo University Hospital. A review has been going on for more than a year. There is concern about the provision of the laboratory and the provision of other capital projects in the region as a result of the children's hospital cost overrun. Will the Minister outline a timeline for when it will be provided, particularly against the superior influence, it seems, that the Minister of State, Deputy Halligan, has over Deputy McLoughlin from the Minister's party in terms of the provision of a second cath lab in Waterford while we still wait for one in Sligo.

Deputy McLoughlin has plenty of influence within the party structures and the Government structures. I thank Deputy MacSharry for the question. The Government is committed to ensuring that all citizens have access to safe, high-quality and evidence-based care, in line with international norms. Sligo University Hospital, which I had the pleasure of visiting recently, provides high-quality healthcare to the people of Sligo, Leitrim, south Donegal and west Cavan. At present there are two cath labs based in Galway that service acute cardiac cases for Sligo and the north west. For elective cases there is a mobile cath lab unit that operates two days per week in Sligo.

It is important to note that specialist cardiac catheterisation laboratory services are provided in a small number of hospitals to ensure that the services provided achieve the required standards of safety, quality and sustainability in the interests of patients. I want to check whether there is a fair distribution of these throughout the country because I have heard the concerns of Deputy MacSharry and others about how they are located. For this reason, I established the national review of specialist cardiac services. This is ongoing and it is expected that its work will be completed in June. The aim of the review is to identify where we should have the cath labs to achieve optimal patient outcomes at population level and an optimal configuration of a national adult cardiac service.

As set out in the national development plan, investment in such laboratories and other cardiac services nationally will be informed by the outcome of the national review. This was sought by Deputies on all sides of the House. It will provide us with the detailed information we need by June, and I will certainly act on it then.

I thank the Minister, but unfortunately the facts do not bear out what he has said. Is the review that was commissioned and begun in January 2018 being prepared in Aramaic, hieroglyphics or some other ancient text or form of writing? It does not take a year. I do not mean any personal disrespect to the Minister, but increasingly Ministers are becoming commentators, and very expensive commentators at €190,000 a year, telling us a review is taking place. A five year old child looking at the map could tell us about the gaping wound in the north west with no cath lab while there are two in Waterford. Before anyone from Waterford attacks me for saying Waterford is not entitled to them, I am not saying that. I am saying it is clear what type of review is required. Clearly, it is just a tactic to state it is under review. When did the last meeting of the review group take place? When is it reporting? How much does it cost? We must tell the truth to the people in the north west.

We do have to tell the truth but I would not have a five year old deciding where to locate our specialist cardiac services.

Perhaps we should when we look at some of the decisions that have been made.

Perhaps we should but I would like doctors to decide that. The national review of specialist cardiac services is independently chaired by the very eminent Professor Phillip Nolan who is president of Maynooth University. He is an independent chair. The aim of the national review is to achieve optimal patience outcomes at population levels. The scope of the national review is broad and was welcomed by many in the Deputy's party. It is badly needed. The report will examine services for adults that address elective, urgent and emergency need for hospital-based diagnosis and treatment of cardiac disease. That will include diagnostic and interventional cardiac procedures and associated interdependent services.

There are 15 members on the steering committee. The Deputy will be pleased to know they include healthcare professionals and, crucially, patients. Patient advocacy is important in this area. Officials from the HSE and my Department are also on the steering committee. The review will also consider responses gathered from public consultation. There has been an opportunity for people, including those from the north west, to have an input into review and I believe a number of people from the Deputy's part of the country gave their views. The steering committee will report in June. It will recommend the best service configuration for a national adult cardiac service. I understand how important and sensitive this matter is in the north west. That was made clear to me on my recent visit to Sligo.

The problem we have is the overrun in the national children's hospital and all of these capital projects we are told are now going to be put on hold. There is no specific information on which projects will be affected yet but we are all concerned. St. Patrick's Hospital in Carrick-on-Shannon and Shiel Hospital in Ballyshannon are both new hospitals and have been announced, expected and celebrated in press releases and photocalls by the Minister and his colleagues. Many capital developments are due to take place in Sligo University Hospital. There were also lots of photocalls, etc., but the Government should show us the money and the building. When are these projects going to happen?

We are worried about the level of autopilot and commentary from the Government. I do not mean that personally, but that is how this looks. We want leadership from the Minister and the Taoiseach. They should show us the money and tell us the facts. We certainly do not want the kind of autopilot that seems to be at play in the context of the national children's hospital. It appears that will have an adverse impact on the provision of a cath lab for the people of the north west. There is none there at the moment. Some 550 people a year, treated at the moment at a cost of €10.6 million to the Exchequer, are being shipped to Galway for treatment. The cost to rent the temporary truck that wheels in two days each week is €3.6 million, as the Minister mentioned. If that money was banked, it would make much more sense to finance a cath lab and put the staff in place as well.

That was a good effort but there is no linkage between the national children's hospital and the decision to provide a cath lab in Sligo.

There is one budget.

Let me explain why that is the case. We will make that decision on the cath lab in Sligo based on the clinical advice and the report that will be given to us by the national review group in June. I do not think that is being a commentator; that is asking medics and patients to come together under an independent chair and look at the best and fairest way to distribute specialist services across our country. While the national children's hospital will take up approximately 20% of my Department's capital budget - by the way 25% of our population comprises children - 80% of the budget will be spent on items that have nothing whatsoever to do with that hospital. There will be significant increases in capital expenditure in health. That is clear to see. The budget for the next ten years is almost €11 billion compared to just €4 billion for the past ten years. That will enable us to invest in furthering services in the north west, not just the cath lab but the additional bed block that is badly needed at Sligo University Hospital. I will keep the Deputy informed as this review comes to a conclusion this summer.