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Help me understand the 24/7 Heart Attack care report

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  • Registered Users Posts: 671 ✭✭✭ Quintis


    AdMMM wrote: »
    Are you not even open to the possibility that the methodology used to calculate the catchment area is flawed, or sub-optimal? Even when you consider that the Department that commissioned the report briefed him that they didn't think it was warranted?

    I don't think anyone is questioning Dr. Herity's credentials, but do you not accept that he could have made a mistake?

    Yes, but no one has yet to come forward with another methodology for calculating catchment that disputes this number, the figures mentioned to contradict Dr. Heritys report don't seem to be based on any recognized formula


  • Closed Accounts Posts: 1,107 ✭✭✭ O Riain


    FA Hayek wrote: »
    AdMMM wrote: »
    Are you not even open to the possibility that the methodology used to calculate the catchment area is flawed, or sub-optimal? Even when you consider that the Department that commissioned the report briefed him that they didn't think it was warranted?

    I don't think anyone is questioning Dr. Herity's credentials, but do you not accept that he could have made a mistake?

    Of course there could be a mistake, no one is infallible but you have to do better then that. You have to prove on the basis of medical need.

    People do not like the conclusion of the report yet are unable to articulate anything other then throwing toys out of their pram.

    What about what Dr. Rob Landers and Dr. Patrick Owens have said? Do their views that this report is flawed not matter?


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    scout353 wrote: »
    If one life is saved because the facility in Waterford is open after 5pm then that is justification enough.

    I know of one person who happened the have a heart attack at 4.50pm and thus was treated successfully in WUH. If that had happened at 5.10pm then a trip to Cork would have been required and that person would have died!

    Why should people be discriminated by virtue of their address? And that question applies across a lot of areas!!!

    That is a wider issue for rural Ireland who expect world class services on their door step paid for of course by the larger urban centres. I can tell you that is the trade off of living in rural areas. This mindset belongs to the 1950's.

    If you want to point fingers, point it at the spatial strategy followed by the state since the foundation of the country which allowed disparate one off developments everywhere, populations spread out and no concept of consolidating services in larger urban areas.

    We are now living with this mess. The tide has turned though. Ireland is the fastest urbanising country in the EU, the more people who live in the city and less in the county means we can finally modernise much of the state and policy decisions.


  • Closed Accounts Posts: 1,107 ✭✭✭ O Riain


    But that's not what's being discussed here. We are not talking about a report on Air Ambulances, we are talking about a report on a second Cath lab in the South East.

    You are coming out with awful fanciful stuff like building a motorway to Cork in order to make ambulance access quicker! My god do you even realise how much that would cost?

    Can you also comment on Waterfords waiting times going up by 161% since being managed by Cork? You seem to think this centralisation of healthcare in Cork is the way to go but it doesn't seem to be doing us any good in the south east.

    Also, what was emotional in what I just said? 40 minutes is a hell of a long time when your having a medical emergency!


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    O Riain wrote: »
    What about what Dr. Rob Landers and Dr. Patrick Owens have said? Do their views that this report is flawed not matter?

    Well, less so because they have a vested interest. I thought that would be obvious. The only person who did not have a vested interest is Dr Herity. Lets give him the benefit of the doubt.


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  • Registered Users Posts: 7,399 ✭✭✭ Nonoperational


    Do people think it's feasible to run a 24/7 primary PCI centre with 2 consultants? Do people think it's feasible or safe to increase the number of,consultants in Waterford to the number needed to run a 24/7 primary PCI service? If you're doing primary PCI you need to be doing lots of it. Cork have 7 consultants operating the PCI rota.


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    O Riain wrote: »
    But that's not what's being discussed here. We are not talking about a report on Air Ambulances, we are talking about a report on a second Cath lab in the South East.

    You are coming out with awful fanciful stuff like building a motorway to Cork in order to make ambulance access quicker! My god do you even realise how much that would cost?

    Can you also comment on Waterfords waiting times going up by 161% since being managed by Cork? You seem to think this centralisation of healthcare in Cork is the way to go but it doesn't seem to be doing us any good in the south east.

    Also, what was emotional in what I just said? 40 minutes is a hell of a long time when your having a medical emergency!

    Did you not post a link stating more resources will be given to Cork, which I presume will help with those waiting times?

    Building roads is not fanciful. Roads are built everyday. There is one being built right now from Tuam to Gort. Having an M25 type road was in the works before the bust.

    Air ambulances are also not fanciful, in fact there is one operating right now from Athlone which does great work and gets people, mostly in the West to Trauma care in Galway. It was a pilot scheme initially but will more then likely become permanent and will be extended over time once services are consolidated in the major centres of excellence. Money would be much better off spent on that then Cardiac care in Waterford

    As I said, before if you live in the Berra peninsula in Cork, travel time to CUH could be up to 120 minutes. Should there be a cardiac centre in Bantry?

    Nothing but emotional Joe Duffy style debating


  • Closed Accounts Posts: 1,107 ✭✭✭ O Riain


    FA Hayek wrote: »
    O Riain wrote: »
    But that's not what's being discussed here. We are not talking about a report on Air Ambulances, we are talking about a report on a second Cath lab in the South East.

    You are coming out with awful fanciful stuff like building a motorway to Cork in order to make ambulance access quicker! My god do you even realise how much that would cost?

    Can you also comment on Waterfords waiting times going up by 161% since being managed by Cork? You seem to think this centralisation of healthcare in Cork is the way to go but it doesn't seem to be doing us any good in the south east.

    Also, what was emotional in what I just said? 40 minutes is a hell of a long time when your having a medical emergency!

    Did you not post a link stating more resources will be given to Cork, which I presume will help with those waiting times?

    Building roads is not fanciful. Roads are built everyday. There is one being built right now from Tuam to Gort. Having an M25 type road was in the works before the bust.

    Air ambulances are also not fanciful, in fact there is one operating right now from Athlone which does great work and gets people, mostly in the West to Trauma care in Galway. It was a pilot scheme initially but will more then likely become permanent and will be extended over time once services are consolidated in the major centres of excellence. Money would be much better off spent on that then Cardiac care in Waterford

    As I said, before if you live in the Berra peninsula in Cork, travel time to CUH could be up to 120 minutes. Should there be a cardiac centre in Bantry?

    Nothing but emotional Joe Duffy style debating

    Waterford is not "Rural Ireland" and comparing it to the Beara Peninsula just goes to show how out of touch you are on this whole thing.


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    O Riain wrote: »
    Waterford is not "Rural Ireland" and comparing it to the Beara Peninsula just goes to show how out of touch you are on this whole thing.

    Shifting the goal posts again.


  • Registered Users Posts: 65 ✭✭ evani1976


    There is a hugh difference in how patients present. A critically ill patient post cardiac arrest should be the basis of what is the medical need. This patients need is have access to a cardiologist and a cath lab within two hours from all geographical areas in the South East.

    How can this be possible if an ambulance has to respond to a stricken patient up to an hour east of UHW e.g Rosslare, Kilmore Quay.?

    Surely this is when a helicopter should be used from designated population centres i.e. Dublin, Cork, Galway, Limerick and Waterford.


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  • Closed Accounts Posts: 1,107 ✭✭✭ O Riain


    FA Hayek wrote: »
    O Riain wrote: »
    Waterford is not "Rural Ireland" and comparing it to the Beara Peninsula just goes to show how out of touch you are on this whole thing.

    Shifting the goal posts again.

    You are the one who brought up the comparison?


  • Registered Users Posts: 18,627 ✭✭✭✭ road_high


    O Riain wrote: »
    No, because it is much bloody closer to Waterford than Dublin. As I said before, even the extreme north of Kilkenny is closer to Waterford than Dublin, yet 75% of KK goes to Dublin? That's a handy one to prop the numbers up!

    If the old way of doing things was dead then we would be getting the university upgrade and the hospital sorted. The old way is very much still alive in Waterford boy!

    Have the Doctors in St. Luke's, Kilkenny that actually send the patients to James's and, are I assume quite happy with this situation, spoken at all and in support of this unit being placed in WUH?
    I mean surely if they saw a huge risk in the status quo then they would to change it and have better outcomes which appears to be the mantra of Halligan and his band of medical experts?

    Just because something is closer does not make it superior (Carlow is equidistant to Dublin or Waterford and account for a lot/half of St. Luke's patients)...I know if it were me I'd sooner go to Dublin for that whole extra half hour journey and be pretty confident I'd be getting the very best attention- this is why we have Centres of Excellence in Cancer care etc.


  • Registered Users Posts: 18,627 ✭✭✭✭ road_high


    Couldn't agree more. Herity should have questioned why consultants in St. Luke's are sending their patients 2 hours+ to James/Mater/Vincents in Dublin rather than 50 minutes to their regional acute hospital; UHW. They have being doing this since before the breakup of the Southeast health region, in fact part of the reason it was diced and sliced to suit Dublin and Cork medical empire builders.

    Because they are doing what they consider best for their patients? It's what most good Doctors I assume do...not because they have some axe to grind with WRH/WUH. (I can do my house in kk to St. James's in an hour flat (in my car, not an ambulance ;) so not sure where the 2 hours plus is coming from?)


  • Registered Users Posts: 375 ✭✭ invara


    Herlihy took 20 pieces of silver from the Government Dept that commissioned him and his report. He is a UCD graduate, and part of the Belfast team that are in discussions with sharing services with Dublin for high end cardio services. Independence is a relative concept Mr. Hayek. The real Hayek had a better understanding of incentives than you appear too.

    FA Hayek wrote: »
    Well, less so because they have a vested interest. I thought that would be obvious. The only person who did not have a vested interest is Dr Herity. Lets give him the benefit of the doubt.


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    road_high wrote: »
    Have the Doctors in St. Luke's, Kilkenny that actually send the patients to James's and, are I assume quite happy with this situation, spoken at all and in support of this unit being placed in WUH?
    I mean surely if they saw a huge risk in the status quo then they would to change it and have better outcomes which appears to be the mantra of Halligan and his band of medical experts?

    Just because something is closer does not make it superior (Carlow is equidistant to Dublin or Waterford and account for a lot/half of St. Luke's patients)...I know if it were me I'd sooner go to Dublin for that whole extra half hour journey and be pretty confident I'd be getting the very best attention- this is why we have Centres of Excellence in Cancer care etc.

    This, already noted that it is better to be a patient in one of the centres of excellence where you are going to get a vastly superior service and better outcomes then a local hospital because its that bit closer. People are looking at this in purely one dimensional terms, as if the distance is the sole and only factor.

    It points to nothing more then localism.


  • Registered Users Posts: 18,627 ✭✭✭✭ road_high


    invara wrote: »
    Herlihy took 20 pieces of silver from the Government Dept that commissioned him and his report. He is a UCD graduate, and part of the Belfast team that are in discussions with sharing services with Dublin for high end cardio services. Independence is a relative concept Mr. Hayek. The real Hayek had a better understanding of incentives than you appear too.

    Oh right so it's all one big conspiracy theory then and Halligan et al are more expert than he is in this medical field....right


  • Banned (with Prison Access) Posts: 1,084 ✭✭✭ FA Hayek


    invara wrote: »
    Herlihy took 20 pieces of silver from the Government Dept that commissioned him and his report. He is a UCD graduate, and part of the Belfast team that are in discussions with sharing services with Dublin for high end cardio services. Independence is a relative concept Mr. Hayek. The real Hayek had a better understanding of incentives than you appear too.

    Ah, now Herity is corrupt. Got it. It is all a conspiracy by those Dublin doctors.
    I suppose if you believe in fairies then anything is possible.


  • Registered Users Posts: 18,627 ✭✭✭✭ road_high


    FA Hayek wrote: »
    This, already noted that it is better to be a patient in one of the centres of excellence where you are going to get a vastly superior service and better outcomes then a local hospital because its that bit closer. People are looking at this in purely one dimensional terms, as if the distance is the sole and only factor.

    It points to nothing more then localism.

    People in Carlow and Kilkenny and surrounds have been going to Dublin for years for medical treatments, it's what we do and are used to. Works fine for the most part. It would be lovely if we had it all on our doorstep but such is life (we are a small country with limited resources) and we do have some very good facilities here. St. Luke's and Aut Even and also the 2 hospitals in Waterford.


  • Registered Users Posts: 375 ✭✭ invara


    Not a conspiracy theory. Just politics. Herlihy exculded in his demographic analysis people who live 5.4 km from the front door of UHW. He did this based on the terms of reference given to him by his customer.
    FA Hayek wrote: »
    Ah, now Herity is corrupt. Got it. It is all a conspiracy by those Dublin doctors.
    I suppose if you believe in fairies then anything is possible.


  • Registered Users Posts: 592 ✭✭✭ Dunmoreroader


    FA Hayek wrote: »
    Better specialist care and better outcomes with more lives saved at the end of the day.

    If you had the choice of a regional hospital with average facilities but was a bit closer or a hospital with world class facilities, services and consultants but was a bit further away, which one would you pick?

    The idea that the nearer hospital will always be the best choice is an ancient idea that belongs in the 1950's.

    Now I know the stock answer will be, just build a world class facility in Waterford, but again Ireland does not have the density of population or the money to provide world class services in every county.

    We have been spreading resources too thin for decades which leads to sub standard outcomes. The past 15 years we have tried to create centres of excellence with great success for cancer care for example. People were outraged about it but the stats and facts prove that this type of care works. Once the benefits are self evident no one wants to go back to the old model.

    You seem a little ill informed about the status of UHW; it's not one of the small hospitals fighting against consolidation to regional centres of excellence - its (supposed to be) one of the centres of excellence.
    Unfortunately to mis-quote Orwell; " All centres of excellence are equal, but some are more equal than others"


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  • Registered Users Posts: 1,853 ✭✭✭ Deise Vu


    It is truly extraordinary the number of people posting here and in the media who are screaming parish pump politics despite the vast swathe of statistics showing standards are dropping alarmingly in the SE while things are improving in Cork. In the interests of balance has it not dawned on them yet that this might indeed be parish pump politics but in the Cork direction?


  • Registered Users Posts: 1,777 ✭✭✭ BBM77


    Deise Vu wrote: »
    It is truly extraordinary the number of people posting here and in the media who are screaming parish pump politics despite the vast swathe of statistics showing standards are dropping alarmingly in the SE while things are improving in Cork. In the interests of balance has it not dawned on them yet that this might indeed be parish pump politics but in the Cork direction?

    Absolutely, I mean the lack of equality the southeast has to face in terms of government provision in general is truly jaw dropping. 24 hr cardiac care is just the current example. Sure the west and mid-west regions got and held on to 24 hr cardiac care without even a hint of any kind of review and they both have smaller populations than the southeast and account for a smaller percentage of the total population of the country. To me this is about fairness. If the government is going to reduce cardiac care in a recession to save money do the same thing for all regions. Why should we have to take extra cuts to maintain services in other areas? For all the people posting about parish pump politics this is the reality of the parish pump politics that is taking place. The campaign to restore 24 hr cardiac care in Waterford is only to get the equality that we deserve.


  • Registered Users Posts: 1,853 ✭✭✭ Deise Vu


    BBM77 wrote: »
    Absolutely, I mean the lack of equality the southeast has to face in terms of government provision in general is truly jaw dropping. 24 hr cardiac care is just the current example. Sure the west and mid-west regions got and held on to 24 hr cardiac care without even a hint of any kind of review and they both have smaller populations than the southeast and account for a smaller percentage of the total population of the country. To me this is about fairness. If the government is going to reduce cardiac care in a recession to save money do the same thing for all regions. Why should we have to take extra cuts to maintain services in other areas? For all the people posting about parish pump politics this is the reality of the parish pump politics that is taking place. The campaign to restore 24 hr cardiac care in Waterford is only to get the equality that we deserve.

    Interesting article in the Indo of all places:

    http://www.independent.ie/opinion/columnists/colette-browne/lowry-could-show-naive-halligan-a-thing-or-two-about-getting-things-done-35043967.html


    One rule for the ruling classes, the 4-seat constituency can make do with home made stents.


  • Registered Users Posts: 592 ✭✭✭ Dunmoreroader


    Here's another piece of shoddy biased journalism from Mick Clifford in The Examiner;
    http://www.irishexaminer.com/viewpoints/columnists/michael-clifford/wrestling-with-his-conscience-has-been-a-constant-since-john-halligan-took-up-role-420143.html

    A Cork man I think, he has the gall to insinuate health spending for Dublin and Cork might suffer unfairly if the 2nd cath lab was provided at UHW;
    "Why should a sick person in Donegal, or Dublin’s inner city, or West Cork be denied health resources because Fine Gael require John Halligan’s vote?"

    Btw, isn't amazing how many of these articles can't even get the name of the hospital right. So far I've seen Waterford Hospital, Waterford General Hospital, WGH. At best it's just lazy journalism, at worst it's vexatious deliberately attempting to downgrade the hospital in the minds of readers to the status of Roscommon or Nenagh, in an attempt to downgrade the strength of the argument for equal treatment. Of course by changing the name Waterford Regional Hospital to University Hospital Waterford, though trumpeted as an upgrade, the HSE was really removing the Regional role for the hospital to the advantage of Cork University Hospital and various Dublin hospitals.
    Divide and conquer with a little help from their friends in the press.


  • Registered Users Posts: 1,777 ✭✭✭ BBM77




  • Registered Users Posts: 2,227 ✭✭✭ Chiparus


    FA Hayek wrote: »
    This, already noted that it is better to be a patient in one of the centres of excellence where you are going to get a vastly superior service and better outcomes then a local hospital because its that bit closer. People are looking at this in purely one dimensional terms, as if the distance is the sole and only factor.

    It points to nothing more then localism.

    Not exactly true, Primary angioplasty is superior to thrombolysis but only if provided within 90 minutes.


  • Registered Users Posts: 498 ✭✭ Teebor15


    Looking at the report, the map outlining the 90 minute catchment area. As bad we are, South Wexford is even worse affected but I haven't heard a peep from any of there TD's. Is it because the main hospital in the region just happens to be in Waterford and they don't want to recognise that?

    Same with the Kilkenny TD's. JP Phelan is a Kilkenny TD and lives in Ferrybank but does'nt seem interested in supporting a hospital 5 miles away! Again is it the usual "County Jersey" BS?


  • Registered Users Posts: 2,227 ✭✭✭ Chiparus


    Teebor15 wrote: »
    Looking at the report, the map outlining the 90 minute catchment area. As bad we are, South Wexford is even worse affected but I haven't heard a peep from any of there TD's. Is it because the main hospital in the region just happens to be in Waterford and they don't want to recognise that?

    Same with the Kilkenny TD's. JP Phelan is a Kilkenny TD and lives in Ferrybank but does'nt seem interested in supporting a hospital 5 miles away! Again is it the usual "County Jersey" BS?

    It goes both ways , if Wexford gets a new Emergency department , the most vociferous opposition comes from Waterford.


  • Registered Users Posts: 592 ✭✭✭ Dunmoreroader


    Chiparus wrote: »
    It goes both ways , if Wexford gets a new Emergency department , the most vociferous opposition comes from Waterford.

    Really? I don't think any right-minded person whether from Waterford or elsewhere would begrudge Wexford General or any other hospital a new ED. However, if budgets for investment in UHW were diverted for new ED's in Wexford or elsewhere(oh say St. Luke's KK off the top of my head), contrary to HSE stated policy of developing regional centres of excellence, then that would be a different kettle of fish, wouldn't it.
    Wouldn't vociferous opposition be justified in such a scenario, far fetched and extreeeeeeeeeeeeemely unlikely such a thing might happen?


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  • Registered Users Posts: 13,922 ✭✭✭✭ Johnboy1951


    FA Hayek wrote: »
    This, already noted that it is better to be a patient in one of the centres of excellence where you are going to get a vastly superior service and better outcomes then a local hospital because its that bit closer. People are looking at this in purely one dimensional terms, as if the distance is the sole and only factor.

    It points to nothing more then localism.

    One would like to think so.

    It seems to apply to all other 'centres of excellence' but not Waterford University Hospital, where the services in question are only available 9-5 :eek:

    Can you tell us why?


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