A number of Sundays ago, a gentleman suffered a cardiac event and was resuscitated on the ground outside University Hospital Waterford, UHW. Even if he had been inside UHW, a model 4 hospital in our great Republic, he could not have accessed cardiac care as the cath lab was closed, which it is 129 hours of every week. Sadly, that man passed away two days later in UHW. Ar dheis Dé go raibh a anam. Where is the 24-7 cardiac service the Taoiseach promised the south east?

The Taoiseach extols his Government's capital spending programme and the hundreds of millions spent in Cork delivering a new airport runway, two new €100 million teaching blocks for University College Cork, UCC, the new convention centre and the Dunkettle interchange. Contrast this with how Waterford has been treated. There has been no capital budget approved for the South East Technological University and a review of a land purchase to add to the Waterford campus footprint has now been going on for 14 months. While UCC is granted a new school of medicine, the engineering buildings promised to Waterford Institute of Technology in 2012 have been deferred to 2026 or later. The Taoiseach's Government has starved our airport of regional aviation funding, threatened the retention of our air-sea rescue service and offered nothing to address the 20-year-old problems of the N24 and N25 road networks in the south east. However, it is the obstruction of capital funding for University Hospital Waterford that offers the greatest insight into the denial of 24-7 services for the south east.

I wish to respect the House's long-standing convention of not making charges against persons here under privilege but I need to balance that convention against my responsibility to identify the sharp practice with regard to the capital and clinical resourcing of UHW by the Cork-based South/South West Hospital Group. Lies are being told regarding the present strategic development of capital and clinical resourcing at UHW and those responsible must stop or be stopped. A recent three-year national study on heart attacks allied with three years of blue light patient transfer data makes the case for 24-7 services for the south east clinically unassailable, yet the Government chooses to ignore this information, preferring to jockey and await the further steered reports required to give it the answers it wants to provide it with the political cover it seeks. Such actions reveal an implicit understanding that the private and public patient streams and numbers of students that flow out of the south-east region and sustain the medical and academic privilege of Cork and Dublin must never be threatened or diminished by competition.

The Taoiseach's Government is abandoning his backbenchers in the south east, just as he has abandoned his promise to deliver 24-7 cardiac care to the south-east region. They will have to answer to the electorate. Without political redirection, I predict that the ballot boxes of the south east will bring a heart-stopping arrest to the political careers of many of the Taoiseach's colleagues in government and in his own party, Fianna Fáil.

I will make one key point to the Deputy first of all. He said that we are waiting for clinical reviews to get political cover. Anybody who knows anything about how healthcare has evolved over the past 20 years will know that clinical expertise has been the driver and has occasioned courageous political decisions with regard to modernising healthcare service in this country. Politics likes to ignore the harsh advice that comes from the bodies that set the various standards such as the College of Anaesthesiologists of Ireland, the Royal College of Surgeons in Ireland and the authorities on cardiology. It is wrong to suggest it is all politics. No politician wants to close anything in any hospital. I have never come across a politician who willingly says that he or she wants to close a given service. However, the politicians of the parties of successive Governments receive advice as to what is optimal with regard to patient safety in given locations.

I remember when emergency medical technician, EMT, was hardly recognised as a profession in this country. The most important thing for a person who has a heart attack is the first responder, rather than how close the hospital is. Thankfully, we have professionalised the role of EMTs through the Pre-Hospital Emergency Care Council, PHECC, initiative we undertook more than 20 years ago. That type of modernisation has resulted in a dramatic reduction in the number of deaths from cardiovascular issues. This country has some of the best survival rates in Europe with regard to cardiovascular issues. We need to have a debate that is balanced and that shows perspective. What we were doing in the past with regard to cardiovascular and cancer healthcare was all wrong. We have changed that over two decades with the result that we are now number one in the European Union league table of lifespans. However, we conveniently ignore all of that when endeavouring to get local political advantage, which I respectfully suggest is what the Deputy is about. He summed it up in his last paragraph when he reduced all of this to politics and said that someone would pay an electoral price for not going wholesale against advice received from cardiologists and clinicians, whether we like that advice or not.

The Deputy knows well - he has engaged with me and other Members of this House on the matter - that we have put investment into a second cath lab in Waterford. That funding is just in terms of the facility. Recruitment in order to staff the new cath lab is ongoing. As I have informed the Deputy previously, the lab will be available for use in October. A total of 24 whole-time equivalents have been approved by the South/South West Hospital Group to staff the second cath lab.

More broadly, employment in the south east increased by 13.6% year on year which is a really strong performance and the Deputy should acknowledge that. The Government approved more than €120 million through the urban regeneration and development fund for Waterford, and still the Deputy comes in here and says the Government is ignoring and does not care about Waterford. What he says does not stack up.

The Taoiseach said I reduced it to politics; I actually did not. He did when he stood in the grounds of University Hospital Waterford with the Minister of State, Deputy Butler, and made a commitment to deliver 24-7 cardiac care to the south east. In recent weeks, I presented to the Dáil data from a three-year National Office of Clinical Audit report along with three years of patient ambulance transfer times for University Hospital Waterford that show that the average transfer time for a cardiac patient was three and a quarter hours, which is totally outside any clinical assessment where they can have any benefit of getting into a cath lab.

I was in the room in 2012 with Ambrose McLoughlin and James Reilly when the commitment was given to deliver a second cath lab to University Hospital Waterford. Here we are eight years later and we still do not have delivery on it. Beyond that, the Taoiseach talks about the report that is due out and the clinical evidence. There is no clinical evidence. There is evidence now from a three-year National Office of Clinical Audit report and we have ambulance data. However, the Government chooses to do nothing about it. In Waterford, the South/South West Hospital Group is running around claiming it is implementing the 24 whole-time equivalents. What has it recruited? It has recruited one porter and one cardiac physiologist. That is what it has recruited so far on the basis of a promise that was given 18 months ago. It is not about delivery and it is not about politics. I am here for the people of the south east and Waterford who I represent. The Taoiseach should represent them and deliver on his promise.

The Deputy knows that is not the case. The existing cath lab has four whole-time equivalent approved consultant posts. An additional intervention cardiologist post was filled on a permanent basis on 1 March.

Will it deliver 24-7?

The Deputy is now upping the ante. When I met him at the commencement of this Dáil, getting that second cath lab in place with staff was a key priority for us all collectively.

That was two and a half years ago.

That was the Deputy's priority and the priority of everybody here.

That was two and a half years ago.

I accept there are delays in getting the construction and so on because of Covid and all the rest of it. I cannot go down there and build it myself. However, we have committed the resources to doing it and we have asked the South/South West Hospital Group and the HSE to get on with it as fast as they possibly can - both the physical facility and the resources.

Regarding the broader situation in Waterford, there needs to be balance. The south east is progressing. The Government was very concerned about the economic performance of the south east and wanted to improve on it. The foreign direct investment performance in the region has been strong over the past five years, with employment among IDA Ireland clients increasing by 25%. The Deputy knows that PublicRelay, Horizon Therapeutics, Eirgen Pharma, Infosys and Tegus all provide substantial employment. Exchequer funding of €14.3 million to date has been provided for the technological university, which is very good for Waterford and for the south east in general.