Help me understand the 24/7 Heart Attack care report

debok · 28-10-2016 11:09am

Good to see any money available is going to good cause anyway in mayo.;!

http://www.thejournal.ie/mary-robinson-library-3050924-Oct2016/

danjo-xx · 28-10-2016 6:41pm

Bit off topic but just announced 12 bed closures due to staff shortages.

JMT2016 · 31-10-2016 11:51am

Dunmoreroader wrote: »

Interesting take on our woes in the Sunday Independent magazine. Dr Gueret's analysis is good but his conclusion misses the point about Ardkeen/WRH/UHW being the Regional hospital for Wexford too.

The south east cardiac care campaign featured again in Dr Gueret's Sunday Independent column:

An entertaining and controversial piece - but does it get to the crux of the matter?

"I am in trouble on my next trip to Waterford for daring to suggest that its politicians are not up to the mark, and that the county needs improved fertility services to rise its population. My flippant remarks followed the recent Herity report that advised against a second heart laboratory to keep local arteries open through the night. My letters tray brims with indignation. One city dweller wrote to tell me that I was being unduly harsh. "Mossy boy," he wrote, "were we to go chasing fertility services, as you helpfully suggest, we would, in all likelihood, by told to go **** ourselves."

There is a palpable sense of local injustice since the Independent Alliance were led up the garden path. The real story here lies deep in rivalry between Waterford University Hospital and neighbouring St Luke's Hospital in Kilkenny. Kilkenny sends many heart patients to St. James's in Dublin rather than Waterford, and this lies at the crux of the issue about whether Waterford rightfully has a regional population of half a million people, or a lot less.

Kilkenny is only a county hospital. Waterford is supposed to be the regional one, but local Fine Gael politics mitigates against it. Within days of the decision against them, Health Minister Simon Harris was down in neighbouring Kilkenny singing the praises of its local hospital. He was in the company of the party's TD for Carlow/Kilkenny, a man born and educated in Waterford.

This row has the potential to be a heartbreaker, and will run and run. Until it's decided how safe it is to keep critically ill patients waiting until morning, or rushing around backroads in the back of ambulances."

JMT2016 · 01-11-2016 11:26pm

Good to see even more coverage of the South East cardiac care campaign, this time in the Waterford News & Star.

First time I have seen comments from Dr. Michael Conway, consultant cardiologist at St. Luke's Kilkenny and this week there is an interview with him. If only he and consultants from Clonmel and Wexford had been asked for their input into the Herity report. It mightn't have resulted in 74% of Kilkenny and 94% of Carlow being omitted from the population of the South East!

Anyway the article says

"Dr. Conway said that he was personally "very keen" to support UHW but that "unfortunately things have arisen and Kilkenny and Waterford are not more in tow as a result of the Higgins Report".

"Overall, the design of the Higgins Report makes things impractical between St. Luke's and UHW. We would love to have more services available locally but it's quite complex. As as result of the hospital groupings, Cork are in the picture with Waterford and we don't have anything to do with Cork. I personally cannot do much. The interaction should be better and I'm sure it will be better in time. I would be able to work in terms of Kilkenny sending patients to Waterford but it's not for me to judge. The answers are not easy."

Every Wednesday University Hospital Waterford's Cath Lab is set aside for referrals from St. Luke's. However, instead of travelling to Waterford to carry out procedures like angiograms and putting in stents, Dr. Conway travels to St. James's, a referral practice that pre-dates UHW's Cath Lab. Consultants cardiologists in Wexford and South Tipperary both take up their weekly option in University Hospital Waterford.

Dr Conway reiterated that he would be interested in keeping services more local and aid he will discuss the possibility of doing more screening in Waterford and using UHW's services to start to do angiograms in the Cath Lab.

It is great to hear from the people actually involved "on the ground" - I think it goes a long way to explaining what is happening and how outcomes for south east heart attack patients can be improved.

TheQuietFella · 03-11-2016 9:16pm

http://www.independent.ie/irish-news/health/pensioner-died-on-trolley-in-busy-ae-10-hours-after-being-admitted-with-chest-pains-35185723.html

Just on the Indo' It's not just Waterford that is being affected.

Country has gone to pot!! If ANYONE in this county has got the balls then I urge them to take a stand against
the political system and lead the revolution by voting AGAINST the current parties in Government in any up
and coming elections.

robtri · 03-11-2016 9:39pm

TheQuietFella wrote: »

http://www.independent.ie/irish-news/health/pensioner-died-on-trolley-in-busy-ae-10-hours-after-being-admitted-with-chest-pains-35185723.html

Just on the Indo' It's not just Waterford that is being affected.

Country has gone to pot!! If ANYONE in this county has got the balls then I urge them to take a stand against
the political system and lead the revolution by voting AGAINST the current parties in Government in any up
and coming elections.

and who do we vote in ??

as you have ruled out

FF
FG
SF
Lab
SD
Ind
PBP
AAA
Renua
i am sure i missing one or two others...

gctest50 · 03-11-2016 9:56pm

TheQuietFella wrote: »

http://www.independent.ie/irish-news/health/pensioner-died-on-trolley-in-busy-ae-10-hours-after-being-admitted-with-chest-pains-35185723.html

Just on the Indo' It's not just Waterford that is being affected.

Country has gone to pot!! If ANYONE in this county has got the balls then I urge them to take a stand against
the political system and lead the revolution by voting AGAINST the current parties in Government in any up
and coming elections.

And the other parties will magically make PEA detectable ?

"There is no technology that can monitor for a PEA arrest,"

Doomed anyway :

.............. 79, coronary heart disease and a thrombosis against a background of lung and renal problems

JMT2016 · 05-11-2016 11:46am

JMT2016 wrote: »

First time I have seen comments from Dr. Michael Conway, consultant cardiologist at St. Luke's Kilkenny and this week there is an interview with him.

I think the comments of Dr. Conway are very important because, since the Herity report, it is being constantly said that 24/7 heart attack care should not be provided for medical reasons.

Now we have all of the cardiologists in the south east saying that they think that these services should be available "locally", these are the medical experts on the ground, most of whom were not asked for their input into the Herity report.

Also, removing the population of Kilkenny and Carlow was the main reason in the Herity report to say that there wasn't enough demand for the service. We now know that there is a dedicated afternoon in the existing Cath lab for Kilkenny and Carlow patients and from Dr. Conway's comments we also know that this is not used for bureaucratic reasons not medical reasons. You could paraphrase Dr. Conway saying "I'm very keen to support WRH...but won't be..." but it's not because he thinks it's in the best clinical interests of patients it's clearly because of bureaucratic barriers caused by the Higgins report amongst other things.

Simon Harris says he won't do anything not "clinically recommended" - the clinicians do recommend it - but the bureaucrats don't!

And the Herity report is a report for bureaucrats! Why didn't the report mention the existing facility for Kilkenny & Carlow patients already in place in the UHW Cath Lab? Perhaps because it would highlight bureaucratic failings and waste that result in it not being used by those patients! Talk about a report justifying the status quo!

Let's not forget there are 20 of these Cath labs already in Dublin. The South East is only looking for 2 and to provide an emergency service that works more than 40 hours a week for a region!

How could the Herity report ever "clinically recommend" 24/7 emergency heart attack healthcare if it never bothered to ask most of the clinicians across the south east who recommend it?

fricatus · 06-11-2016 11:59am

It's not online, but the Phoenix column in this week's News & Star makes for very bleak reading. I hope he's wrong, but he's usually been right on the money when it comes to the hospital. We really need transparent government and decision-making in this country.

robtri · 06-11-2016 5:41pm

fricatus wrote: »

It's not online, but the Phoenix column in this week's News & Star makes for very bleak reading. I hope he's wrong, but he's usually been right on the money when it comes to the hospital. We really need transparent government and decision-making in this country.

how much more transparent do you need it to be... it is clear as daylight the government does not consider 24 care in Waterford any sort of priority.. Our politicians have also show very transparently how little they care about it as well, especially Halligan... (Mr I will reign down hell on the government....as he rolls over lets Enda tickle his belly as he collects his pay)

I think it is very transparent by the government on their position

fricatus · 06-11-2016 7:34pm

robtri wrote: »

how much more transparent do you need it to be... it is clear as daylight the government does not consider 24 care in Waterford any sort of priority.. Our politicians have also show very transparently how little they care about it as well, especially Halligan... (Mr I will reign down hell on the government....as he rolls over lets Enda tickle his belly as he collects his pay)

I think it is very transparent by the government on their position

No, transparent government would make clear the steps and process by which the decision was arrived at. The way things are in this country, all that's obvious is the final outcome, and then all we can do is speculate about the reasons why we were shafted.

It's clearly political, because the population within 30, 60 and 90 minutes of Waterford is very similar to that of Limerick and Galway, and there was no talk of reviews or reports in either of those places. However who is working against us, and what are their reasons, are the questions that we're left wondering about.

robtri · 06-11-2016 7:48pm

fricatus wrote: »

No, transparent government would make clear the steps and process by which the decision was arrived at. The way things are in this country, all that's obvious is the final outcome, and then all we can do is speculate about the reasons why we were shafted.

they did .. its called the Herity report... the steps and process are clearly identified in it....

invara · 06-11-2016 10:07pm

JMT2016 wrote: »

Quote:
"Dr. Conway said that he was personally "very keen" to support UHW but that "unfortunately things have arisen and Kilkenny and Waterford are not more in tow as a result of the Higgins Report".

"Overall, the design of the Higgins Report makes things impractical between St. Luke's and UHW. We would love to have more services available locally but it's quite complex. As as result of the hospital groupings, Cork are in the picture with Waterford and we don't have anything to do with Cork. I personally cannot do much. The interaction should be better and I'm sure it will be better in time. I would be able to work in terms of Kilkenny sending patients to Waterford but it's not for me to judge. The answers are not easy."

Every Wednesday University Hospital Waterford's Cath Lab is set aside for referrals from St. Luke's. However, instead of travelling to Waterford to carry out procedures like angiograms and putting in stents, Dr. Conway travels to St. James's, a referral practice that pre-dates UHW's Cath Lab. Consultants cardiologists in Wexford and South Tipperary both take up their weekly option in University Hospital Waterford.

Dr Conway reiterated that he would be interested in keeping services more local and aid he will discuss the possibility of doing more screening in Waterford and using UHW's services to start to do angiograms in the Cath Lab.

Worth looking at Dr Conway's tortured language..... he makes two kinds of statements in the quotes attributed to him

First he repeats over and over again how ..... IT IS NOT MY FAULT

"unfortunately things have arisen"
"We would love to have more services available locally but it's quite complex"
"I personally cannot do much."
" it's not for me to judge. "

Second he alludes to impersonal forces over and over again (using an impersonal or omnipresent voice) when dealing with the curious situation of Kilkenny transporting its patients to Dublin and refusing to engage with Waterford

"The interaction should be better and I'm sure it will be better in time."
"The answers are not easy."
"I would be able to work in terms of Kilkenny sending patients to Waterford"

The article does not explain why he refers his patients to St Vincents.

Higgins as an excuse does not cut it for two reasons- Wexford is not in the Waterford/Cork group but they refer to Waterford; Higgins himself attended a meeting with Waterford TDs and said how upset he was that the promised Cath lab was reneged on because of the Kilkenny referral pathway.

Explicitly Dr Conway should address who is responsible for determining referral pathways if it is not him as the lead cardio consultant in St Luke's. What does he (or the other person who calls the shots) require for the referral pathway to be changed.

TheQuietFella · 14-11-2016 7:24pm

http://www.wlrfm.com/news/local/86994-waterford-consultant-resigns-as-clinical-director.html

I suppose when it boils down to this, it puts all of the local politicians to shame!

JMT2016 · 19-11-2016 11:31am

Just an update on the deteriorating situation - wait until all UHW patients will be referred to Cork....

http://www.wlrfm.com/news/local/88075-60-cardiac-patients-from-uhw-being-referred-to-cork.html

60 cardiac patients from UHW being referred to Cork

Up to 60 patients who are waiting for non emergency cardiac procedures are to be referred to Cork because University Hospital Waterford does not have the capacity to treat them.

Waterford Sinn Fein TD David Cullinane has slammed the government for its continued refusal to address capacity issues at University Hospital Waterford.

He says "Dozens of cardiology patients are being transferred to Cork because University Hospital Waterford continues to suffer from significant capacity constraints."

JMT2016 · 06-01-2017 8:33pm

New Year New Protest

WLRfm

A mobile cath lab for University Hospital Waterford falls far short of what's needed for the South East region, according to a patients' advocacy group.

Waterford Junior Minister John Halligan has indicated that a proposal for a mobile laboratory is expected to be approved by Health Minister Simon Harris.

There are currently 800 patients waiting for cardiac procedures at UHW, according to the TD.

Mr Halligan told the Examiner newspaper that the mobile unit would reduce the waiting lists in the hospital and within a year he could see the Government and the HSE being forced to accept the need for a second cath lab.

However, The South East Patients Advocacy Group says the people of the South East will not be easily 'placated' wtih temporary fixes.

A second protest march is planned for Saturday the 14th of January at 2pm.

Max Powers · 07-01-2017 11:35am

It's a possible way for govt to look like they not caving in and for us to get what we ultimately need in the region,24/7.

All we ALL can do now is do march next Saturday,14th.for third time for some of us but keep up pressure.

azimuth17 · 07-01-2017 3:47pm

I believe the HSE are currently in the process of moving hundreds of UHW waiting list (cardiology)patients to Cork. Why would they do that if Simon Harris was in favour of a mobile lab?

Johnboy1951 · 07-01-2017 4:03pm

azimuth17 wrote: »

I believe the HSE are currently in the process of moving hundreds of UHW waiting list (cardiology)patients to Cork. Why would they do that if Simon Harris was in favour of a mobile lab?

To prevent unnecessary deterioration or death of patients until the unit is in operation?

I hope the numbers are properly recorded so true figures for each region can be ascertained.

robtri · 07-01-2017 9:24pm

all I can say is Halligan..... sep 11
" I will reign hell on this Government"

also Red line issue

what a useless self serving leech.....

now they offer us a mobile Lab... a ****ing caravan!!!!

Wanderer78 · 07-01-2017 9:47pm

robtri wrote: »

all I can say is Halligan..... sep 11
" I will reign hell on this Government"

also Red line issue

what a useless self serving leech.....

now they offer us a mobile Lab... a ****ing caravan!!!!

not at all, hes now feeling the wrath of big party politics. not much is gonna change in this country unless we can find a way of changing the two big parties or create a party that can challenge them

Wanderer2010 · 08-01-2017 11:02am

robtri wrote: »

all I can say is Halligan..... sep 11
" I will reign hell on this Government"

also Red line issue

what a useless self serving leech.....

now they offer us a mobile Lab... a ****ing caravan!!!!

He hasnt resigned I see. And he never had any intention of resigning. Even if the government had said straight out to him "You will never ever ever get anything for Waterford from us" he still wouldn't have budged. Why would he? Big salary, massive expenses that he claims and free dinners and photo ops almost every night. Hes not going to let a few angry people stop him living his life. Typical self serving useless politician. We were the fools to vote him in.

Johnboy1951 · 08-01-2017 11:53am

Wanderer2010 wrote: »

He hasnt resigned I see. And he never had any intention of resigning. Even if the government had said straight out to him "You will never ever ever get anything for Waterford from us" he still wouldn't have budged. Why would he? Big salary, massive expenses that he claims and free dinners and photo ops almost every night. Hes not going to let a few angry people stop him living his life. Typical self serving useless politician. We were the fools to vote him in.

You have personal information and knowledge that this is true?

Reads more like a whinge from someone who is dissatisfied with themselves and wants to bring others down with them.

Wanderer2010 · 08-01-2017 1:00pm

Johnboy1951 wrote: »

You have personal information and knowledge that this is true?

Reads more like a whinge from someone who is dissatisfied with themselves and wants to bring others down with them.

Hmm, great counter argument there. Blaming projection. I voted for Halligan because I believed he would make a huge push for the cardiac services in Waterford and I even believed him (stupidly) that he wouldn't back down on this. Turns out the government were going to screw him from Day 1. Its now obvious, between misleading reports and secret visits from the Health Minister, that we are as far away from increased cardiac support now than we ever were. There's even another protest this Saturday regarding same.

Halligan hasn't resigned as he said he would, he hasn't "rained down hell" as he said he would, it was all posturing and bluff to hold on to any support he got from his campaign to change Waterford for the better, where he exploited the frustrations of a jaded constituency who craved something different from the usual chancers Coffey and FF. We were cheated. He wont resign because he has it handy- a ministerial wage, huge expenses claiming (I got this from the Freedom of Information Act by the way), events and dinners where he hasn't to pay a cent and a massive pension awaiting him.

Don't forget too he also signed the Eviction Bill which can turf people who fall on hard times out of their house with the minimum of hassle and its all legal, he put his name to that. He doesn't care about Waterford, he only cares about his own skin.

azimuth17 · 08-01-2017 2:02pm

Its very hard to disagree with your summation of the facts Wanderer 78. I think in fairness that Coffey (and I am not an FG supporter) has spoken out twice in the Seanad about cardiology services in fairly trenchant terms. Deasy has said he accepts the Herity Report and refuses to answer queries I believe, from local media. Mary Butler has accepted the FF long finger and D Cullinane has done a good job in obtaining information, but how long will it be before SF are in government. I expected more from John Halligan, although I did not vote for him, when he got himself into a Healy Rae position.

Max Powers · 08-01-2017 3:10pm

robtri wrote: »

all I can say is Halligan..... sep 11
" I will reign hell on this Government"

also Red line issue

what a useless self serving leech.....

now they offer us a mobile Lab... a ****ing caravan!!!!

IMO, halligan and deasy have proven to be absolutely useless.butler is actively working against Waterford on the boundary.David cullinane just has to sit and say nothing to be our best TD at this stage.I have never voted SF but its actually a relief he is there.

azimuth17 · 08-01-2017 5:03pm

Apologies my last post should have read wanderer 2010.

Wanderer78 · 08-01-2017 11:00pm

i still stand by my statement above, politics is a finicky 'game', theres a lot of power play at play. our two main parties have ruled the roost for too long and like power, so much so, sometimes they make decisions that arent necessarily in the best interest of the country, but to guarantee their position of power, theres plenty of evidence to show this throughout our political history. as i said previously, i do feel, this is exactly whats happening with halligan, but maybe there is personal reasons why he has done what he has done, who knows, i may find out this at some stage if i have a chat with him. i do think he was a bit naive going into government, but at least hes giving it a shot, its not an easy job, not a job i think id be able to do. halligan is using the threat of resignation to try 'play the game', but unfortunately the odds are seriously stacked against him, this is largely due to the power play of our political system. we truly need to move on from ff and fg in order to move our country forward, but unfortunately there isnt really any party ready to take their place just yet, my opinion of course. some commentators are now saying that we may see a reversal of roles between ff and fg after the next election, this is a possibility, and we roll on for another couple of years with not much happening. time will tell i guess. this in turn is frustrating the hell out of me, theres some really serious problems developing in our country as we speak and some potentially extremely serious problems developing external to ireland that could cause serious problems for our country. if we dont get our house in order soon, really really bad things could potentially be facing us soon, of which we have very little control over. to rob a michael hudson phrase, i think we re potentially facing 'a slow car crash', no wonder hudson is known as dr doom:)

Johnboy1951 · 09-01-2017 12:34pm

Wanderer78 wrote: »

i still stand by my statement above, politics is a finicky 'game', theres a lot of power play at play. our two main parties have ruled the roost for too long and like power, so much so, sometimes they make decisions that arent necessarily in the best interest of the country, but to guarantee their position of power, theres plenty of evidence to show this throughout our political history. as i said previously, i do feel, this is exactly whats happening with halligan, but maybe there is personal reasons why he has done what he has done, who knows, i may find out this at some stage if i have a chat with him. i do think he was a bit naive going into government, but at least hes giving it a shot, its not an easy job, not a job i think id be able to do. halligan is using the threat of resignation to try 'play the game', but unfortunately the odds are seriously stacked against him, this is largely due to the power play of our political system. we truly need to move on from ff and fg in order to move our country forward, but unfortunately there isnt really any party ready to take their place just yet, my opinion of course. some commentators are now saying that we may see a reversal of roles between ff and fg after the next election, this is a possibility, and we roll on for another couple of years with not much happening. time will tell i guess. this in turn is frustrating the hell out of me, theres some really serious problems developing in our country as we speak and some potentially extremely serious problems developing external to ireland that could cause serious problems for our country. if we dont get our house in order soon, really really bad things could potentially be facing us soon, of which we have very little control over. to rob a michael hudson phrase, i think we re potentially facing 'a slow car crash', no wonder hudson is known as dr doom:)

Halligan was/is most likely a bit naive and would lack the larger and more experienced advice available from having a large party behind him.
He seems to have reckoned he could (and even did) gain what he hoped, only to find 'the small print' caught him out.
Not a nice situation in which to find oneself, particularly when in the public eye.

My own view is that all party loyalty should be left outside the 'houses', and representatives should be seated without party sections.
There should be no party loyalty on any issue except those that affect how political parties themselves operate.

The 'government' could consist of representatives that their fellow representatives vote for, with those 'thus elected' selecting their leader.
It would then be up to those 'in government' to agree policy etc by majority, and put major decisions before the main body.

Some form of scheme is badly needed to get rid of the 'choke-hold' that political parties have on proceedings.
Of course the only way to achieve that (destruction of the political party power base) is to have a revolution, which is not going to happen.

So we are stuck!

Wanderer78 · 09-01-2017 1:26pm

Johnboy1951 wrote: »

Some form of scheme is badly needed to get rid of the 'choke-hold' that political parties have on proceedings.
Of course the only way to achieve that (destruction of the political party power base) is to have a revolution, which is not going to happen.
So we are stuck!

i beg to differ there regarding a revolution, i beleive there actually is a revolution of sorts going on, maybe im naive to think this but, its regularly termed 'the progressive movement' or what i like to term 'an intellectual revolution' and its global. id have to agree with david mcwilliams that in difficult political times or times of crisis, what seems like radical ideas, can be found being implemented very quickly. i beleive we re potentially facing a collapse of the euro and maybe even the eu in the near future, if this happens, and i really hope it doesnt, we may find radical ideas being implemented rather quickly. this is a very interesting time in global politics but on the other hand, its also very worrying.

i will agree with you though, we currently are kinna stuck with our current system and what i thought was gonna happen is more or less happening, i.e. i suspect we re gonna have a couple of crappy governments with little or nothing truly changing, and we re waiting for something major to happen in irish and global politics in order to shunt it a long. its frustrating to watch

Help me understand the 24/7 Heart Attack care report

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