December 17, 2015
Deputy John Deasy asked the Minister for Health the position regarding the provision of a 24/7 cath lab at University Hospital Waterford.
REPLY (Minister Leo Varadkar):
Services at the Regional Cardiac Catheterisation Laboratory (cath lab) at University Hospital Waterford are led by three Consultant Interventional Cardiologists and their teams. This service is developing in line with best practice and the national clinical programme for acute coronary care.
The cath lab in UHW performs approximately 40 invasive cardiovascular procedures each week and offers a comprehensive range of invasive and non-invasive diagnostic services. This includes the insertion of stents, pacemakers and implantable defibrillators.
Primary PCI is undertaken with STEMI heart attacks which are about 20% of all heart attacks. It is done in a cath lab by an experienced cardiologist. The cath lab in UHW is open five days a week from 8.30 a.m. to 5.30 p.m.
Patients who require Primary PCI outside these hours are transferred to Cork University Hospital or to a Dublin hospital. However it is important to note that 24 hour, 7 day a week consultant medical cover for cardiac patients is provided in UHW.
I am aware that UHW is committed to the progressive extension of the current PPCI service. However, the reality is that any extension to the service will require significant investment, both capital and revenue. 24 hour emergency PPCI cover requires, as a minimum, two cath labs on site. It also requires a minimum of 6 interventional cardiologists.
As for any complex acute hospital service, a key criterion for deciding whether a 24 hour PPCI service should be provided, is whether there is sufficient volume of appropriate patient activity to ensure the safe provision of the service. Without sufficient volume of service, staff will not be in a position to maintain their skills and in those circumstances, it will not be possible to provide a safe service.
Funding for new developments is limited and it is of critical importance that the available funds are targeted appropriately. UHW is a constituent hospital of the South South West Hospital Group.
The priority to be afforded to the expansion of the PPCI service in Waterford must first be considered from a hospital group perspective and in relation to the planning for the cardiology needs of the Group population. The development must then be considered in a national context, and in the light of competing demands for scarce resources.
This proposal remains to be considered and prioritised by the HSE. (Further reply to issue directly from HSE.)