Minister John Halligan used “erroneous” figures to overstate level of cardiac services at Waterford Hospital

THE head of the HSE’s national programme for coronary care said Minister John Halligan had misrepresented patient numbers to overstate the level of cardiac care services being provided at Waterford Hospital.

Prof Kieran Daly – clinical lead for the National Programme for Acute Coronary Syndrome – said that Halligan had used “erroneous” figures in an RTÉ radio interview.

In an email sent to HSE colleagues, Prof Daly said Mr Halligan had tried to compare the level of cardiac care being provided at the Mater Hospital and St James’ Hospital in Dublin with his own local hospital in Waterford.

In the message, Daly wrote: “This is erroneous and a misinterpretation of the ACS [Acute Coronary Syndrome] 2014 report where it was clearly pointed out figures for [the Mater] … were an underestimate because of incomplete data collection.”

The email was one of dozens of records released under FOI by the Department of Health about extending cardiac services at Waterford Hospital.

An upgrade of services has been a key demand of Minister of State John Halligan in return for supporting the government, and is currently the subject of an official review.

Professor Daly – in his email – explained that there was no comparison between service provision in Waterford and Dublin hospitals as Mr Halligan had suggested on radio in April of this year.

He said: “Currently [the Mater] and [St James’ Hospital] provide 24/7 cover for the larger Dublin area and broader catchment and deserve huge credit for the volume of cases dealt with.

“Both units average approx. 300 STEMI [heart attack] cases per year which is at least twice the activity of Waterford. Similar comparisons apply to other cardiology activity.”

Professor Daly asked that his concerns be raised with Health Minister Simon and his Department as part of a national review of coronary care which was originally given just a six-week deadline for completion.

The documents also reveal that Mr Halligan was coming under “immense pressure” to guarantee that a service was delivered for Waterford.

Just two weeks after the review began, his parliamentary assistant wrote to the Department of Health saying that Minister Halligan was “very anxious” to see how it was progressing.

“He is coming under immense pressure to ensure it is delivered. I urgently await hearing from you,” an email explained.

Within another week, Minister Halligan’s office was back on seeking an update saying “this is really quite urgent – we are now coming up on three weeks – half way into the six-week time frame”.

Although the documents are heavily redacted in parts, the Department of Health were aware that the short timeline originally set for the review was going to prove difficult.

An email sent to Professor Daly said: “Obviously we do not want to look at Waterford in isolation and at the same time fully appreciate the difficulties in completing the national review in the 6-week window we have been given.”

In a later letter sent from Minister Simon Harris to John Halligan, the timeline for the national review was later extended to three months.

Mr Harris said it “would not be possible” to complete it within the window originally provided and the review has only now been concluded.

The documents also reveal that concerns were being raised over whether the population of Waterford could justify enhanced cardiac care services. Ireland’s National Cardiovascular Policy set out criteria for 24-hour services with one centre intended for every 500,000 to 1 million population.

A briefing note explained: “Information from the 2011 census indicates that the population of Waterford is 113,795, well below the minimum threshold.

“While of course the [hospital] catchment goes beyond the county boundary and serves part of Wexford, South Kilkenny and South Tipperary, the 2011 census data … shows that the entire population of the South East would not have a sufficient population to sustain a 24 hour … service.”

Neither the HSE or Department of Health would comment in detail on the concerns raised about Mr Halligan’s figures pending the review.

The HSE said: “The Department of Health commissioned an independent report regarding cardiology services at Waterford University Hospital. The HSE awaits the outcome of this report.”

An edited version of this post appeared originally in last week’s Irish Mail on Sunday.

A selection of the documents are below

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