Tuesday, 17th July 2018
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Regarding the recent announcement by Minister of State John Halligan that Government has sanctioned the deployment of an interventional Modular Cath lab to University Hospital Waterford - this to counter the ever increasing delays to interventional cardiac access in the South East:

Health Equality for the South East (HEFSE) is very concerned with the detail given in Minister Halligan's statement appears to be premature, unknown at Senior Department and HSE Cabinet level and appears to have restrictions to delivery imposed not applicable to other cardiac service delivery sanctioned at other national PCI centres in past 18 months! At a public accounts committee last week post the announcement, questions raised by Deputy David Cullinane to both HSE and Dept of Health confirmed that: - Department of Health has not yet officially informed the HSE of a decision to instigate a modular lab on site at UHW

- HSE acknowledged that without such an official directive no activity planning whatsoever can begin in terms of procurement, possible site or local government planning requirements, recruitment engagements.

These aspects have been under consideration by the Minister and his Department seniors for a 7 month period and yet despite Minister Halligan's statement saying a clear Ministerial instruction had been activated and underway, the facts outlined at the Public Accounts Committee display no such understanding on the part of those charged with delivering on the initiative!

Secretary General at the Department of Health, Jim Breslin, admitted that he was working on issuing such a directive to HSE but given 7 months have already elapsed one wonders how long more should this process take?

It appears the only expanded treatment we in the South East can receive are further declarations of government empathy and concern, allied with promises of future action but don't expect any obvious activity plan to deliver. In other words More Platitudes, More Promises, but absolutely No Provision! HEFSE also questions aspects of the proposal referring to requirements to planning permission, construction tendering and procurement - all conspiring to extend the delivery to 18 months and beyond. Such requirements are at odds with the original business proposal given to the Minister, Department of Health and HSE in early January 2018. Specifically this proposal highlighted the Modular nature of the lab which is a delivered temporary structure to site and therefore should not require planning permission. In addition there is only one expert provider of such a facility who is approved by HSE and deemed capable and experienced in delivery of such a facility with contracted service. They are at present engaged in providing several modular units to Irish Healthcare and HEFSE argues why procurement requirements cannot follow the precedent of 'restricted tender' of 17 days used to fast track delivery of two new interventional cath labs to St Vincents Hospital in July 2017 – estimated cost 10 million euro! The fact is that the South East is now again being 'strung along' with promises of service enhancement but with the caveat of significant potential delay being placed in the delivery process.

This will further damage south east cardiac service numbers in terms of the ongoing national review and can be seen as further proof of a deliberate policy to constrain cardiac activity in the South East region into the future. This has huge social and economic implications for the South East is completely at odds with the Governments 2040 supposed aspirations. HEFSE is calling on all south east Oireachtas members including Ministers Keogh, Phelan and Halligan to immediately galvanise and demand agreed timelines to this modular lab proposal.

This service could be implemented within 3 months or less if the political will is there - that the time frame under suggestion is of the order of 18 months is further evidence as if more was needed that timely, accessible cardiac care for south east patients is a secondary issue for those directing national health policy. Minister Harris is complicit in this service refusal - he has refused to make himself available to meet South East Oireachtas members on this issue since February 2018, despite repeated requests to do so. HEFSE would ask voters to remember well this continual lack of government engagement to this regional issue and 'reflect in kind' when electoral canvassers begin calling to your door in the near future!

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