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The man who reviewed Waterford's cardiac care defends decision on no second lab

Cardiologist Dr Niall Herity has concluded that University Hospital Waterford does not need a second cath lab.

pjimage Source: Rollingnews.ie

THE CONSULTANT CARDIOLOGIST who conducted an independent review of cardiac services at University Hospital Waterford (UHW) has said that in his opinion there is no need for a second catheterisation laboratory at the hospital.

Dr Niall Herity, a consultant based in Belfast, was tasked with conducting the independent review by Minister for Health Simon Harris.

His conclusions are at odds with Waterford TD and government minister John Halligan’s demands for the hospital, and have left Halligan’s ongoing membership of government in extreme jeopardy.

They are also at odds with the opinions of the chief clinical director at UHW Dr Rob Landers, who yesterday told RTÉ he was “shocked” by the conclusions of the review.

Speaking to RTÉ’s Morning Ireland today, Herity said that he was “absolutely” happy with the terms of reference he was given regarding the review and that his work was not being tailored in any way.

“At the start of the summer I was given the terms of reference, and I was specifically asked whether there was a need for a second cath lab,” he said.

Herity explained the methodology he used to come up with a figure of 286,147 as the catchment population for the existing cath lab.

UHW University Hospital Waterford Source: Google Maps

His figure is just over half the 500,000 population catchment figure expressed by Dr Landers.

“I analysed patient flows coming from those regions of counties in the southeast as to where they go for their catheterisation,” Herity said.

Some go to Cork, some go to Dublin, some go to Waterford primarily.
I analysed county by county and used the 2016 census to get the most effective estimate of catchment population in coming up with my figure.

Asked whether the fact that many catheterisation laboratories in Ireland are open 24 hours, while the existing Waterford lab is only open nine-to-five, makes any difference, Herity replied ”not at all”.

“The vast majority of work done in cath labs is pre-planned, done on a nine-to-five basis,” he said.

96% of the work done in Waterford is pre-planned, with 4% emergency work. Only a tiny amount of cath lab work is done out of hours.

Herity added that, contrary to public perception, he believes the recommendations he made in his review are “quite a substantial expansion”.

“I’ve noted that the current capacity for cath lab procedures in Waterford is not adequate, and I’m recommending that the capacity be increased by about 20%,” he said.

I didn’t conclude that there was a need for a second lab, but I did conclude that the cardiology, the funding, and the staffing at the existing lab be increased so that the capacity is 12 sessions a week rather than 10.

“I have recommended substantial investment, just not a new cardiac catheterisation laboratory,” he added.

Asked whether or not he thought a second review planned by the government for the start of 2017 was necessary, Herity said “I think that is entirely sensible”.

However, if the investment I have recommended is to be reviewed then that is for the minister to decide.

Minister for Housing, Planning and Local Government Simon Coveney was asked this morning about the hospital review and what it meant for Halligan’s position in government.

He said that such reviews are necessary before investment is made and urged Halligan to remain.

“I’ve always said to John, for his priorities to get them done he’s far better off being in government to see them through rather than in opposition but that’s a decision for him,” the minister said.

We want him to stay of course, we want to invest in and support Waterford Hospital and that’s what we’ll do but we can only make investment on the back of clinical reviews that recommend such investment.

- With reporting by Christina Finn

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