Waterford cardiac consultants warn of patient deaths

Cardiac patients could die as a result of the under-provision of services in the South-East, senior consultants in the region have warned.

The consultants have called on Minister for Health Simon Harris to acknowledge that his review of cardiac services in Waterford, published last week, is flawed.

At a press conference in Dublin on Wednesday, they expressed “grave concerns” the report is being used by the Department to radically alter, for the worse, the provision of cardiac care for half a million people in the South East.

The independent reviewed, commissioned on foot of political commitments made to local Minister of State John Halligan, provoked shock in the region by finding against the need for a second catheterisation lab and recommending downgrading of other services in Waterford.

The consultants said they "utterly reject" the findings of the report. "The report conclusions were deeply dismaying, but made all the more so since its eventual publication last Thursday has allowed its flawed nature to be identified," said Dr Patrick Owens, consultant cardiologist at University Hospital Waterford.

Dr Owens said the report wrongly based its estimate of the catchment population for cardiac services in the South East on patient flows to the unit in Waterford, without taking into account constraints on capacity.

“This flaw is like basing the demand for tickets for an All-Ireland final on the number of people of seats in the stadium, rather than the number who want to attend.”

“This fallacy would have been readily apparent had the reviewer visited the consultants in Wexford General Hospital and South Tipperary General Hospital and determined their referral priorities, as their patient advocates. No such consultation occurred.”

The review by Belfast cardiologist Dr Niall Herity found Waterford performed only 62 PPCI interventions on heart attack patients last year, less than the 100 recommended.

In his report, Dr Herity said it would be a mistake to assume the effective catchment area for UHW was represented by every resident of the counties in the region. This would not take account of different levels of cardiac care provided by different hospitals.

Over 95 per cent of the work done in Waterford is planned, and only 4 per cent is emergency work, so moving to a 24/7 cath lab service would make little difference to the calculation of the effective catchment population, he argued.

Dr Owens said this was the number of cases performed during the nine-to-five, five-day weekly operation of Waterford’s single cath lab. “Were out of hours cases to be included, the unit would have comfortably exceeded the minimum requirements.”

He described as “farcical” and “fatuous” a proposal by Dr Herity that the single cath lab should open for longer hours during the week.

Dr Owens, who was accompanied by four colleagues from Waterford, Wexford and South Tipperary hospitals, said there had been no movement on the issue since Friday.

He described the issue was overwhelmingly one of clinical safety and described the “political to-ing and fro-ing” on the issues as “not helpful”.

Asked about his contacts with Mr Halligan, he said he met the Waterford TD last Thursday, just before the report was published, and they spoke on the phone on Sunday.

He described Mr Halligan, who has threatened to resign if the additional cardiac services are not provided, as an “enthusiastic espouser” of the interests of Waterford.