Help me understand the 24/7 Heart Attack care report

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.

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.

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.

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.

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

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.

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"

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.

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.

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.

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.

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?