Wednesday 22 November 2017

Top consultants reject South East cardiac services report

By David tucker

Dr. Aidan Buckley, consultant cardiologist, Wexford Hospital.
Dr. Aidan Buckley, consultant cardiologist, Wexford Hospital.

Senior medical professionals, including consultant cardiologists and the chief clinical director of the South/South West Hospital Group, have utterly rejected the 'flawed' findings of the Herity Report on the provision of cardiac services in the South East.

Speaking at a briefing in Dublin to highlight the plight of the region, they expressed grave concerns that the flawed report has been unchallenged, and yet is being used by the Department to radically alter, for the worse, the provision of cardiac care for the half a million people in the region.

The consultants group in the South East which represent medical professionals from Wexford, Waterford and Tipperary, said the report makes incorrect assumptions that underpin the recommendations.

Rejecting the findings of the Report, the consultants called on the Minister for Health Simon Harris to intervene and meet with them to resolve the ongoing problem of a second cath laboratory as lives are at stake in the South East.

Dr Patrick Owens, Consultant Cardiologist and clinical lead for cardiology at University Hospital Waterford said, the struggle for adequate resourcing for the South East cardiac service has been four years in the fighting.

'This report was the last in a long line of hindrances and procrastinations we have encountered in this struggle, and, as a result, we accepted the process of independent review only under duress. 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 Owens.

'The population calculation in the Herity report is inaccurate. From this figure, all the subsequent recommendations come. These recommendations hugely disadvantage the South East population, limiting still further their access to care, both by withdrawing the prospect of acute heart attack emergency care, and by profoundly under-resourcing the South East Cardiac Interventional Service in University Hospital Waterford.'

Dr Owens said the report determines the effective population size for the unit, by examining the patient flows to the unit.

'However, this approach is flawed. The flaw is best described in the 'Croke Park' analogy, which asks how to determine the number of people who want to come to the stadium to see the All-Ireland Final.

'The method used in the report determines this figure by simply counting the number of people in the stadium. This figure can never exceed the capacity of the stadium (82,300), regardless of the demand. The application of this method for determining the effective population on a capacity-constrained service, such as the South East cath laboratory, leads to erroneously and dangerously low population estimates.'

'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 patients' advocates.

No such consultation occurred. Additionally, had the reviewer discussed his findings with the Cardiac Department at University Hospital Waterford prior to finalising his report, this error would have been highlighted. No such consultation occurred,' said Dr Owens.

He said the primary concern of the South East consultants through this entire sad episode has been to ensure the welfare and safety of cardiac patients in the South East region.

'These concerns were formalised into two terms of reference which we had requested at the outset be presented to the reviewer. These were not presented, and our primary concerns were thus not addressed in the report.

'We entirely accept that constrained resources exist in Irish healthcare. We acknowledge that cardiac services, like all services, must be fair, safe and rational. But we refute entirely the recommendations of this flawed report, resulting as it does in services which are, and remain, unfair, unsafe and based on flawed logic,' said Dr Owens.

Attending the briefing were Dr Rob Landers, Clinical Director, South/South West Hospital Group, Dr Patrick Owens, Consultant Cardiologist and clinical lead for cardiology, University Hospital Waterford, Dr Aidan Buckley, Consultant Cardiologist, Wexford General Hospital, Dr John O'Dea, Consultant Cardiologist, University Hospital Waterford, and Dr Mark Doyle, Consultant in Emergency Medicine and Medical Adviser to the Prehospital Emergency Care Council.

Wexford People

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