Waterford Regional Hospital has lost a top heart specialist to Galway after he became frustrated over the HSE’s failure to commit funding for a full-time cardiac catheterisation lab at Ardkeen.
Dr Briain MacNeill, who came here from Boston, has given notice of his intention to quit his post as Interventional Cardiology Consultant from January. Local hospital staff are thought to be furious at the development which threatens to set the fledgling regional service back considerably – not to mention putting patients under unnecessary stress.
After five years of planning, the unit – which provides diagnostic and interventional angiography services – was built at a total cost of €2.85 million, with a further €1.3m made available by the Health Service Executive to enable consultations to commence on May 1 last.
So far it’s been operating on a two-day-week basis and approval was received last month for a second consultant cardiologist post. However, the senior specialist, having failed to receive sufficient assurances about funding, is leaving for Galway (where he graduated at NUI) – just as an exasperated John Deasy TD had warned.
The Waterford Fine Gael Deputy is “very disappointed that the HSE should have allowed this to happen” given the time and effort put into developing the facility and the relatively small expense involved in making it a five-day service.
The extra €1.4m a year required would pay for itself, he says, as it would enable the HSE to save on the expense of transferring patients to Dublin for angiograms and other diagnostic procedures.
The laboratory proves equal access to services from the region’s four acute hospitals – WRH, Wexford General, St Lukes, Kilkenny and Clonmel. Between start-up and the end of August 229 patients had availed of it, with more than half of these going on to have second interventional procedures. The total has risen to at over 320 since, with a full-time service clearly warranted.
Previously such patients would have experienced delays in accessing services and been obliged to travel to Cork or Dublin. As Deputy Deasy explains, “Effectively the service means a patient can be taken from casualty at Waterford Regional and treated directly at the hospital rather than having to wait upwards of 10 days to be transferred by ambulance with a nurse to St James’s Hospital in Dublin.”
He says the previous service, whereby patients had to be brought to locations outside the region, cost €4m a year.
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The HSE told this newspaper earlier this month that said the lab “remains a regional service priority” and that it “remains committed” to it. However, worryingly, “Additional resources for next year will be determined by the funding available to the Hospital group for 2009”, it said, adding that the recruitment process for a second Consultant Interventionist Cardiologist is expected to fill the position in the first half of 2009.
Mr Deasy said he had contacted Health Minister Mary Harney directly twice on the matter, and she had promised to get back to him after studying data he presented on the cost savings and health benefits that would ensue.
A two-day service would only be able to cater for 600-700 patients per annum as opposed to the 4,000 or so people within the region who require angiography services each year.
“In 2005, some 4,230 people were transferred out of the region to Dublin and Cork for angiography services; in 2006, it was 4,290, and last year the number increased to 4,409 people with approximately one-third of all these referrals being inpatients,” Deputy Deasy said.
Furthermore, “Given that the average wait for accessing inpatient services outside of the region is five bed days per patient and a basic medical casemix cost per bed day of €500, the HSE is spending around €4.1 million while patients await access to services.
“Add in another €500,000 on top of that in ambulance costs and €141,000 on nurses travelling with patients and the entire service is costing close on €5m – from a public policy perspective it’s crazy,” he asserts.
The HSE, confirming it had received notice of Mr McNeill’s decision, says it intends to replace him and also recruit a second consultant in the new year. It reiterated that the lab “will be developed on an incremental basis”, while “in parallel some patients will continue to be referred to other hospitals outside the region until the service at WRH is fully operational.”