Speech by Mr. Ivor Callely T.D., Minister of State for Services for Older People, at the opening of Acute Chest Pain Seminar

Good morning, Ladies and Gentlemen. I am delighted to be here today to formally open this seminar on Acute Chest Pain Assessment organised by the Eastern Regional Health Authority.

Burden of Heart Disease

As you are aware, Ireland has the highest premature mortality rate from heart disease in the European Union. Within the Eastern Region, as in the rest of the country, one quarter of all deaths are caused by heart disease. While death rates have declined steadily in recent years, hospital discharges have actually increased slightly. This reflects the continuing high burden of heart disease in the Irish population.

Improving Patient Care

We all share the aim of enhancing the care of patients with suspected acute coronary syndromes to improve survival and the quality of their lives. To achieve this requires rapid and efficient access to expertise and facilities.

Approximately 1,700 acute myocardial infarction discharges take place each year from hospitals in the Eastern Region.

However that is not the full picture, as substantially greater numbers of patients present to Accident and Emergency Departments with symptoms of chest pain than require admission.

It is recognised that the assessment of these patients and confirmation of AMI, unstable angina, other cardiac events or non-cardiac causes requires dedicated services.

Chest Pain Assessment Unit

Since commencing in September 2001, the Chest Pain Assessment Unit in St. James´s Hospital has provided an efficient and dedicated service to approximately 1,300 patients with suspected acute coronary syndrome.

This Assessment Unit has proven in its first year to be an important step in the diagnosis of patients with a high risk of coronary disease and reducing unnecessary hospital admissions in low risk patients. It has also proved to be a valuable opportunity to assess and advise patients concerning the modification of risk factors.

Seen as a National Pilot Project, this Chest Pain Assessment Unit will assist in the expansion of this model, or other similar models into all acute hospitals, which I know is a key objective for the Eastern Regional Action Plan.

In this regard, I welcome this Regional Acute Chest Pain Assessment Seminar being hosted by the ERHA, which will explore care pathways, models of good practice and service delivery structures.

Cardiovascular Health Strategy

I am now going to set this Acute Chest Pain Seminar into a broader context by saying a few words about the Cardiovascular Health Strategy. Launched in July 1999, the Cardiovascular Health Strategy takes a strategic approach to preventing and treating the high burden of heart disease in Ireland, across all sectors of health care and society.


In its first three years, the Government has invested €45 million towards the implementation of this Strategy. This funding has allowed for the expansion of cardiac services to the public:

  • almost 800 additional staff have been employed, 80% of whom are professional staff,
  • there has been substantial regional development of cardiac diagnostic services and the consequent reduction in waiting times for these services,
  • from the virtual non-existence of cardiac rehabilitation three years ago, the service has expanded so that it is available in almost every acute hospital today,
  • there has been a large increase in health promotion programmes across the country, and
  • a national secondary prevention programme in General Practice will soon be launched which will support the appropriate care of cardiac patients in the community.

This Government is committed to the continued and co-ordinated implementation of the Strategy, within available resources.

Funding to the ERHA

Since the launch of Building Healthier Hearts in 1999, the Eastern Regional Health Authority has invested over EUR10 million in developing services across Health Promotion, Pre-Hospital and Primary Care, Hospital Sector and Cardiac Rehabilitation and are currently finalising an Action Plan for the years 2002-2007.

Part of this investment includes €350, 923 revenue and €288, 865 minor capital for the development of the Chest Pain Assessment service at St. James´s Hospital in 2001 along with chest pain developments in other hospitals.

Future Challenges

The increased numbers of older people living with heart disease together with the availability of treatments for which there is evidence of effectiveness presents major challenges for our health services. The National Health Strategy Quality and Fairness places emphasis on timely access to high quality services.

The opening of the Chest Pain Assessment Unit at St. James´s Hospital is an excellent example of putting these principles into practice.


I would like to pay tribute to the members of the Eastern Regional Health Authority Cardiovascular Health Strategy Steering Group for organising this very important seminar. This Steering Group is representative of a wide variety of key sectors necessary for the successful implementation of the Cardiovascular Health Strategy. One of the working groups of the main Steering Group – the Cardiovascular Hospital Working Group has identified Acute Chest Pain Assessment as a key objective for the Regional Action Plan and the hosting of an Acute Chest Pain Assessment Seminar as the first related action.

I would also like to thank the ERHA for inviting me here today to launch this Acute Chest Pain Assessment Seminar and I congratulate the Authority on this initiative.