Risk rating had ‘no impact’ on Waterford hospital review

Minister for Health Simon Harris has sought to play down concerns of consultants at University Hospital Waterford that its risk rating in relation to the provision of cardiac services was changed just weeks before services were reviewed by an international expert.

The medical board at the hospital said last week that they were "appalled" that a decision was taken at hospital group level to reduce the risk relating to cardiology services in Waterford and the absence of a second catheterisation lab to treat heart attack patients.

A catherisation lab is an examination room in a hospital with diagnostic imaging equipment used to visualise the arteries and chambers of the heart and treat any abnormalities found.

HSE officials in the South/South West hospital group changed the risk posed to patients by the lack of cardiac facilities at University Hospital Waterford in late August from its previous level of 20 (on a scale extending to 25) where it had been for the past three years down to just 16.

But Mr Harris disputed the contention that the risk rating had been changed and said that he did not believe the discrepancy between the hospital's own risk rating and the hospital group risk rating had any impact on a review of cardiac services by external expert, Dr Niall Herity.

“I am trying to seek some clarity on this. I don’t actually believe that the risk register has been changed at all in the last six months. I believe the way that risk was categorised both at the hospital and at hospital group level may have been somewhat different.

“However I can say very clearly that this did not have an impact on Dr Herity’s report. I have met Dr Herity – he went in independently as a clinical expert in this area, he engaged with clinicians in Waterford, he looked at all the data and he made his decision.”

Reneging

The controversy over the review and Dr Herity's decision not to recommend a second catherisation laboratory at Waterford hospital prompted Minister of State for Training and Skills John Halligan to accuse Fine Gael of reneging on a promise to him to provide the facility.

Mr Halligan was due to attend the launch of the Health Innovation Hub Ireland at University College Cork with Mr Harris but he did not.

About 2,000 people protested in Waterford at the weekend about Dr Herity’s decision but Mr Harris was adamant that he was not going to succumb to local political pressure.

"Dr Herity is a very eminent cardiologist and NHS employed. The Programme for Government made a clear commitment that we would carry out an independent clinical review. You could not have got a more independent review than [from] Dr Niall Herity. I have published that review in full."

“Let us be clear because sometimes this gets lost in the chatter of local medical politics. The review does suggest that there are a number of things that needs to happen in UHW and these are issues that the Government will address.

“It says there needs to be more staffing of the cath lab. It says very clearly that there needs to be new equipment in the cath lab. It says very clearly that the cath lab’s opening hours need to be extended but it just doesn’t say there is a need for a second one.

“What I want to do now is rather than engage in any sort of political row here, I want to get on with making the improvements that Dr Herity recommends, investing in the hospital in Waterford. I look forward to visiting it in the coming weeks.”

“What I have said to the people of Waterford and I say it very clearly to them again – let us then look at the impact of those improvements on the volume and number of people using the cath lab. Let us review the situation next year to see if those improvements have changed the situation.”

“I have an obligation as a Minister for Health to be led by clinical advice. We don’t have that [a recommendation for a second cath lab]. If I am to start second-guessing independent cardiologists I think that would put our health service in a very perilous place. It is not something I am going to do.”