Major new initiative on cardiovascular health and cardiac services announced
Brian Cowen TD, Minister for Health and Children today (29th January 1998) announced a radical new programme to tackle cardiovascular disease.
Before announcing details of his new programme, Minister Cowen commended the Mater Hospital for its sterling work over the years and confirmed that it would maintain its position as the National Cardiac Surgery Unit and the centre of excellence for cardiovascular surgery. The Minister stressed that not only would the Mater retain its responsibility for treatment of transplants and congenital heart conditions but it would also be encouraged and supported to play a more active role in the ongoing organisation and development of all aspects of cardiac surgery care nationally.
Cardiovascular disease is the second biggest cause of premature death in Ireland, accounting for almost one third of all deaths in the under-65 age group. For ischaemic heart disease our premature death rate is twice the European average. The National Health Strategy set a target of reducing this death rate by 30% by 2005.
The new initiatives announced today by the Minister are designed to meet this challenge. They are:
- a national strategy to improve cardiovascular health
- additional public cardiac facilities for adults and children
- The development of a national heart/lung transplant programme for patients with cystic fibrosis and other lung diseases in the medium term.
National Strategy for Cardiovascular Health
The Minister said:
” I want the strategy to cover preventive, medical, surgical and rehabilitation services. I want to make clear recommendations on health promotion and education initiatives to tackle the key risk factors, as well as looking at the overall organisation of the services and the adequacy of ongoing research in the causes, prevention and appropriate treatment of cardiovascular diseases”.
The Minister announced the setting up of a Special Working Group to address these and other difficult issues and recommend appropriate steps. The Group is to start work immediately and will engage in an intensive and structured consultation process with all the key organisations, before reporting back in June 1998. The Group will have nine members and willinclude a cardiologist, a general practitioner and experts in health promotion and cardiac rehabilitation. The Minister confirmed that the programme of action recommended by the Group will be adequately resourced.
In the meantime, the Minister intends to strengthen his Department’s existing prevention programmes which target the key risk factors for cardiovascular disease – smoking, diet and exercise. In this regard the Minister proposes to launch a new anti-smoking campaign which will involve the health boards and the voluntary sector. This will include a national helpline supported by a range of local initiatives aimed at helping people quit smoking.
Cardiac Surgery Services
The Minister said:
“My priority is to address the existing waiting lists and the overriding objective when the Strategy is fully in place is to reach an average six month waiting period for those on the list. I am committed to achieving equity of access for public patients to cardiac surgery and to addressing the existing regional imbalances in funding and delivery of cardiac services”.
Regarding the necessary increase in capacity required to deal with the waiting lists Minister Cowen announced the following:-
- Additional paediatric cardiac surgery capacity will be developed at Our Lady’s Hospital for Sick Children, Crumlin in association with the National Cardiac Unit at the Mater Hospital. With up to additional 100 procedures caterered for this increases existing paediatric cardiac surgery capacity by up to 40%. The full year revenue costs of this comprehensive paediatric cardiology/cardiothoracic service are estimated at £2m.
- The development of additional adult public cardiac surgery facilities at St James’s Hospital. Target activity levels will be 450 procedures per annum. The total capital cost is projected at £6.1m with, running costs of £3.73m.
- Cardiac Surgery facilities will be included in the major redevelopment programme currently underway at University College Hospital, Galway. Target activity will be 300 procedures per annum. The capital costs of the cardiac surgery facilities are projected at £7.5m. The running costs of the Galway service when fully operational will be in the order of £2.65m.
- Additional cardiology services are to be put in place at Cork University Hospital to augment the existing cardiac surgery facility there.
Heart/Lung Transplant Service
The development of a heart/lung transplant service on a phased basis is to be implemented in line with the Government’s commitment outlined in the Programme for Government as follows:
- Continuing to improve access to existing facilities in the UK for Irish patients, including improving pre and post-operative care here and by helping to ease the burden on those who have to travel for surgery, as well as their carers. Additional sites in the UK are to be identified for new arrangements.
- Establishing a formal “mentor” link between a centre of excellence abroad and the Irish hospitals who will care for heart/lung transplant patients.
- The Mater Hospital will be the designated surgical site for the proposed heart/lung transplant programme in Ireland, in association with other key service providers, particularly St Vincent’s Hospital, Elm Park which is the National Centre for Cystic Fibrosis. Heart/lung transplant surgery will be commenced in Ireland as soon as the planned service can guarantee results at least on a par with those achieved internationally.
The proposals in relation to the heart/lung transplant programme have been long awaited – especially by those suffering from cystic fibrosis and their families. The Minister expressed his personal commitment to the early implementation of the service.
The Minister said:
“Today’s package of new initiatives reflects the critical importance of tackling the huge problem of cardiovascular disease in Ireland. Whatever is required to address the problem, I, as Minister for Health, intend to do. I will not be deflected from the efforts to meet the targets of the Health Strategy. These measures contain a clear focus on the priority issues with the resources to implement real action. Achieving equity of access for all public patients regardless of where they live; an average waiting time of six months for cardiac surgery, tackling the current backlog through the development of additional cardiac surgery facilities, working towards establishment of a national heart/lung transplant service and the development of an action-oriented National Strategy for Cardiovascular Health are among the most important priorities for me as Minister”.