SINCE the Waterford News & Star broke the news (July 23 edition) that the only cath lab at UHW capable of performing interventional work will soon to be out of action for “up to 12 weeks”, the South-South West Hospital Group has not provided one tangible update, leaving serious questions about the region’s already substandard cardiac care.
On July 31, the Chief Operations Officer with the South-South West Hospital Group (SSWHG), Ger O’Callaghan, emailed Waterford’s Oireachtas members to inform them that UHW consultant cardiologists would set out “detailed contingency plans” for all patients who would normally attend the Cath Lab and that it has been confirmed to him that “this plan will be completed by next Wednesday (August 7).”
As of Monday, August 12, the hospital has yet to confirm (1) when the cath lab will be closing, (2) how long it will be closing for and (3) what will happen to emergency and elective patients while the only interventional cath lab we have is closed.
Here is what we know:
In August of 2018, Chief Operations Officer with the SSWHG, Ger O’Callaghan confirmed that the modular cath lab cannot perform interventional work because “the unit has limited space overall and does not have an admission area or recovery beds”. He stated that the unit is a “temporary building that does not have all of the facilities required for a fully functioning cath lab and would not be a suitable long-term structure”. This confirms that when the current cath lab closes, the temporary one will not be able to take emergency patients.
On July 19, 2019, the SSWHG issued a statement to the Waterford News & Star stating that UHW was “currently progressing preparatory work to facilitate the replacement and upgrading of the existing Cath Lab equipment” and that the new equipment would be installed and functional “before year end”. They added that the “options to manage patients during the equipment installation period are currently being discussed with all relevant parties as part of the preparatory work”.
On July 31, Minister John Halligan posted a statement on Facebook which said:
“Before any work begins, consultants at the hospital will provide a detailed contingency plan as to how service will be delivered during that time. It is expected that this plan will be submitted by mid-week next week (the week of August 5). A timeline of the work will also be submitted by the contractors before any works begin. It’s been widely reported that the refurbishment will take 12 weeks to complete, however I have been told by management that it is likely to be finished in around half that time.”
This contradicted a statement from the hospital itself on July 29, which stated that “the upgrading will take between 10 to 12 weeks to complete.” This statement also stated that “the options to manage patients during the equipment installation and upgrading is currently being discussed and involves the expertise of the Cardiology Team.”
Since July 19, the Waterford News & Star has repeatedly asked the SSWHG when the cath lab would be closing and to confirm exactly how long for. As of August 12, no answers have been provided. When Mr O’Callaghan’s intended date for the publication of a contingency plan (Aug 7) passed, the Waterford News & Star sought details of exactly how the hospital intended to prevent the eventuality of the South East having absolutely no emergency cardiac care at all.
On August 8, they stated that, “Consultations between the UHW management and Consultant Cardiologists at the hospital are ongoing with an outcome expected shortly.” And then, on August 12 they stated, “Engagement with all relevant stakeholders is ongoing to ensure minimal disruption to service.”
Fianna Fáil Cllr Eddie Mulligan said that Gerard O’Callaghan of the SSWHG must be held to account over the non-delivery of a contingency plan after almost a month since news broke of the cath lab upgrade.
“Whilst I understand that the consultants’ input is a necessary ingredient in the process, I actually find it humiliating as a Public Representative that the delays in the Contingency Plan compilation has been deflected and abdicated in responsibility to the consultants,” Cllr Mulligan said. “This is not right and is another unacceptable indication of the apathy by senior management to Cardiac Care in Waterford and the South East. The down time for the current upgrade and work requirements was well-known and the failure to incorporate a contingency solution as a part of the tender is totally unacceptable, which was no doubt driven by costs. Minister Halligan must hold Mr O’Callaghan to account for cardiac care solutions that are on an equitable par to those of Dublin, Limerick and Cork.”
PRO of the Health Equality for the South East, and Independent Councillor Matt Shanahan said that the delays with the contingencies were “another example of health service deflection and dysfunction”.
“There will be no adequate contingency possible for treating emergency heart attack at UHW beyond transfer to an outside centre with all the attendant risks and delays,” Cllr Shanahan said. “The only adequate contingency that could be offered to prevent ambulance transfer would be a second fully equipped interventional cath lab onsite in Waterford. Minister Halligan along with deputies Butler and Cullinane met with Simon Harris in September 2018 and promised us in the South East such a replacement and guaranteed it would be delivered within 17 months. 11 months later and despite the supposed support of four Ministers in the South East all we have of that promise is an architects drawing of a possible cardiac suite build and nothing else. Despite this we are now being treated by HSE to another ‘nothing’ announcement for patient care – that is ‘nothing’ adequate beyond a racing ambulance to Cork while a fit out three years in planning is scheduled to halt services for weeks if not months at UHW. You couldn’t make it up but Government and HSE do every day.”
Sinn Fein TD David Cullinane said that it was “unacceptable that we were still waiting for a contingency plan”.
“The South/Southwest Hospital Group gave all Oireachtas members a commitment it would be signed off on last week. This has not happened,” Deputy Cullinane said. “I have no difficulty with upgrading the Lab but the lack of details from the HSE and their failure to meet targets and deadlines they themselves set is disturbing. It is happening time and again and the Government TD’s need to stand up and be counted.”