Harris said yes to second cath lab in defiance of advice
HEALTH Minister Simon Harris gave the green light to a controversial cardiac lab despite strong recommendations against it from senior departmental officials.
The second cath lab at Waterford University Hospital had been a key priority for Independent Alliance junior minister John Halligan and the proposal was approved by Mr Harris in early July.
However, internal department emails reveal that senior officials did not believe the lab – which is to be built in a prefab – was justified or fitted in with national plans.
In addition, they said a business case put forward by the HSE was out of date, contained factual inaccuracies, multiple miscalculations and could not be used as the basis for any decision.
The minister was given a preliminary briefing on the proposal, which advised against on three separate grounds, on March 29.
Despite that, he asked for the idea to be investigated further in an email sent by one of his special advisers.
It read: ‘I understand that on a recent visit to Waterford this issue was raised with the Taoiseach who said he would ask Minister Harris to examine the issue further.’
The Department of Health subsequently looked for a business case from the HSE and prepared a second briefing for Mr Harris.
Pressure for a decision on the cath lab intensified in June when the Taoiseach’s department also sought updates on the proposal, records reveal.
An internal email from Secretary General Jim Breslin on June 13 said: ‘Following the meeting with Minister and advisors (here and in D/Taoiseach) we have been asked to press the HSE to submit the business case. The submission should include the key steps necessary to commission such a lab, the associated timelines and costs.”
On June 21, an internal email from the minister’s special adviser said Mr Harris now wished to ‘proceed with the provision’ of the second lab and wanted to update TDs in the South East the next day.
Half an hour later, a health official urged: ‘We strongly advise against providing an update to the South East Oireachtas members confirming intention to proceed with provision of a modular cath lab in advance of receipt of the department’s analysis.”
The following day, senior officials provided a second lengthy briefing on the proposal saying there were ‘factual inaccuracies’ and some of the information was out of date.
They also said there appeared to be ‘numerous miscalculations’ in tables of costs. ‘Given the miscalculations referred to, it is also not possible to make a definitive determination on the value for money of the preferred option outlined in the business case,’ it warned.
The briefing listed eight reasons why the plan should not proceed, the first two because of the mistakes in the business plan.
It also said the development – which could cost between €1.85 and €3.4 million a year – was not consistent with the Herity Plan, an independent clinical review that said a second cath lab in Waterford was not justified. It stated the South East could be served by extending the existing lab’s opening hours and that staffing challenges would be a problem if it went ahead.
It concluded: ‘Acute Hospitals Policy Unit 4 strongly recommends the project not proceed at this time, in advance of more detailed information on costs and timelines.”
In a handwritten note, Department Secretary General Jim Breslin also raised the issue of how it would fit in with funding plans.
The previous briefing in March had also strongly recommended against proceeding with the unit.
It warned providing a prefab lab would take anything between 12 and 16 months and was not a viable interim solution during a national review of cardiac services.
In a statement, the Department of Health said: ‘Given University Hospital Waterford’s status as a primary [cardiac] centre, the minister believes there is merit in the proposal for a modular cardio-catheterisation laboratory [there].
‘The HSE has submitted details of the costs and timescales for options for the provision of a modular cath lab to the department for review and further details on costs are awaited.’
‘Strongly recommends project not proceed’