On standing for election I gave a commitment to the people of Waterford city and county and the south east that I would do my utmost for our regional hospital, University Hospital Waterford, and the patients it serves. Yet again, I have to bring the issue of the hospital's under-resourcing onto the floor of the Dáil. Recent work on heart attacks by the National Office of Clinical Audit using data from 2017 to 2020 demonstrates that no patient from the south-east region is getting to alternative cardiac care when the cath lab at University Hospital Waterford is closed. In addition, in 134 blue-light emergency transfers from Waterford to Cork in the years from 2019 to 2022, the average time elapsed was three hours and 15 minutes. The national clinical protocol for heart attack requires cath lab access within 90 minutes from first responder. Every heart attack patient from the south-east region is exposed to additional heart damage and medical trauma and increased morbidity because of the lack of treatments available in the location where it is required, which the Taoiseach promised he would provide.

I have watched the Government walk through walls to build a hospital that is largely for the people of south Dublin. I have watched the Government parties whip their Deputies furiously to get them to support the national maternity hospital project despite misgivings as to its ultimate ownership. I heard the rationale offered by the Tánaiste, our next Taoiseach, in the debate in this House when he stated the maternity hospital needs to be in Dublin because if a woman has a cardiac arrest she can be in ICU within 20 minutes. The Hippocratic oath extends to the people of Waterford and the south-east also.

Over the past two years I have seen the Taoiseach in action. I would say he is a formidable operator. He gets his way. He can build a new runway in Cork in less than six months from a standing start. He can green-light the Dunkettle interchange. He is certainly a man of his word to his electorate and the people of Cork. On behalf of my electorate and the people I represent, I need a simple "Yes" or "No" answer from the Taoiseach today. Will he keep his promise to the people of Waterford and the south east? Will a 24-7 emergency cardiac care service be in place when he leaves the Taoiseach's office in December?

I thank the Deputy for raising this very important issue and generally for his consistency in raising these issues in respect of Waterford University Hospital and the broader constituency. He referenced the national maternity hospital. That was first announced in 2013. It is now 2022. It is questionable as to whether too many walls have been gone through. It took seven years to get to a point where a decision was taken to build it. In the case of Waterford the issue in recent years has been the cath lab. Work on the construction of the second cath lab commenced in March 2021. It will be completed by the end of August. The second cath lab will be available for operational use from the end of October this year. This is in the context of Covid-19, with the shutdown in construction. The second cath lab will mirror the existing cath lab and will be able to undertake the full range of diagnostic, interventional and non-interventional cardiac procedures available in the existing upgraded cath lab.

All consultant cardiology posts are currently filled in the hospital. There is an issue with the recruitment of an additional registrar to support the 8 a.m. to 8 p.m., Monday to Friday service. That position is being recruited as a matter of urgency. A total of 24 whole-time equivalents were approved by the South/South West Hospital Group in November 2021 for the staffing of the second cath lab, which is a significant commitment to the undertakings we gave the Deputies and representatives of the south east. We are awaiting the presentation and publication of the national review of specialist cardiac services. The overall budget of the hospital has increased by about €60 million since January 2020, which is a 20% increase and a significant commitment to University Hospital Waterford.

I accept the Deputy's point about timely care and that having the right care at the right time in the right place is critical. More generally, we want to develop further services at University Hospital Waterford in addition to the second cath lab. In terms of the capital programmes, in particular, as the Deputy knows, a report is expected to be finalised in the coming weeks. That review has been strategically examining the current and future capacity requirements of University Hospital Waterford to ensure that proper planning is in place for the next 15 years to invest in the hospital. The South/South West Hospital Group will work with HSE estates to make the relevant capital submissions for new developments that are required at the hospital. HSE estates has confirmed that a submission will be made at the capital steering committee for the development of additional bed capacity for the hospital. There has been significant investment across Waterford but I do not have time to go into that now. Perhaps it could be given as a supplementary response.

I was hoping for a "Yes" or "No" answer but I understand that the Taoiseach feels he cannot give it. With the additional money put into University Hospital Waterford, it still remains the most underfunded of nine model 4 hospitals in the country. That is the first issue. Second, the Taoiseach talked about the provision of additional services to the cardiac care suite. What he is offering us is an aeroplane with no pilots, baggage people or transportation on the ground to operate it. Without the people, we cannot operate it.

We need a 24-7 service, which the Taoiseach and his party committed to in 2016. The lack of care, attention and interest in following up on this promise over the years is quite evident now. The people of the south east will have their say. Either the service will be in place in December and the Taoiseach's word will have demonstrated its worth or it will not. I apologise to him for saying that but I have to keep the promises I made to fight for this vital service.

We are past reviews. We had 134 blue-light transfers over three years. Not one of them could get out of Waterford to Cork in under three and a quarter hours. It is no longer a clinical case. It is a political decision. It is up to the Government to either follow through on what it promised to do or else not follow through and leave it to the electorate to decide how it appreciates and takes that.

Some 250 new staff, of whom 25 are consultants, have been appointed to the hospital since January 2020. All consultant cardiology posts are filled. I do not know whether the Deputy is equating the consultants to the pilots.

It is not enough.

The consultants might have an issue with that. In any event, there are a fair few pilots there and we want to do more for the hospital.

Do it then.

I have been discussing this issue with the Deputy since January 2020. His issue with me, along with the other Deputies from the south east and Waterford, was to get the second cath lab up and running, and that is happening. We have to get this done step by step. The second cath lab is there. Some 24 whole-time equivalent posts-----

Hold on. Please let me finish. Some 24 whole-time equivalent posts were approved by the South/South West Hospital Group in November 2021 for the staffing of the second cath lab. Therefore, it is not without pilots. It is ridiculous to say it is without pilots.

It is a political decision. It is no longer a clinical decision.

The start dates for two senior radiographers have been agreed. The start dates are awaited for three cardiac physiologists. Recruitment campaigns for ten staff nurse posts and two healthcare assistants are ongoing. Recruitment campaigns for the position of certified nurse midwives, CNM, 1 and 2 are ongoing. The recruitment of four administrative posts and two porters is under way through the national recruitment process for the second cath lab.