John Halligan has claimed a HSE document released under a Freedom of Information request reveals there was "gross interference" with the independent review into the provision of a second catheterisation laboratory for University Hospital Waterford.

An independent review into cardiac care at University Hospital Waterford has concluded that a second specialised laboratory is not justified.

The lab is at the centre of a dispute between Mr Halligan, who is an Independent Alliance junior minister and local TD, and the Government.

Mr Halligan believes that a second lab is needed at the hospital, but the official review, which was commissioned by the Minister for Health in May, has recommended against an expansion.

RTÉ's Prime Time programme revealed details of a briefing note that was prepared for the review's author, Belfast-based consultant cardiologist Dr Niall Herity. 

The note, prepared by the HSE's Acute Hospital Policy Unit 3, referred to the "growing public and political pressure in the Waterford region to build and staff an additional cath lab at the hospital and to expand the existing service to a 24/7 service.

"However it has been the view of the Department that providing additional facilities and extending PPCI (angioplasty) services, in a geographical area which does not have the population base to justify such a service, would be wasteful of very limited resources. 

"Such a unit might struggle to achieve the levels of activity essential to maintain operator and unit competency, potentially compromising patient safety. Staffing an extended service might also represent a challenge."

The report subsequently found that expanding the service to provide 24-hour cover was not a sustainable solution.

The report also concludes that the hospital should cease the provision of primary PCI, also known as urgent angioplasty, and the management of patients should be consolidated in Cork University Hospital and St James's Hospital in Dublin.

It finds that the current activity at the hospital is appropriate to the needs of the effective catchment population, and that the annual needs for patients could be delivered in 12 weekly sessions.

Building a second cath lab is not justified to accommodate the workload, the report finds, as the needs of the effective catchment population for planned cardiac cath laboratory procedures can be accommodated in a single lab.

Mr Halligan said he was shocked at the contents of the briefing document, describing it as a "gross interference with an independent review."

The Waterford TD has also pulled back from an earlier threat to walk out of Government over the issue.

Following consultations with campaigners and cardiac consultants in Waterford, he has agreed to remain in office "for the time being" while he continues to campaign for the provision of the second lab.

Mr Halligan said earlier today that if the Government does not commit to the second catheterisation laboratory he will find it difficult to stay in Government. 

Speaking on RTÉ’s Six One News, Mr Halligan said it was not his intention to create instability or to have a lack of cohesion in Government over the findings of the review.

He said he met consultants and clinicians at the hospital this morning and they had asked that he not leave Government yet.

Mr Halligan said consultants in the south east region wanted to go through the report, which was published this afternoon, and to have a right to reply and to meet the Minister for Health, adding that they, more than politicians, would be able to show how the report is flawed.

Dept of Health to review all primary PCI services - Harris

In a statement, Minister for Health Simon Harris said that following the completion of the clinical review, a number of recommendations were made.

One recommendation was to invest "in UHW to enhance the existing cardiac services, including increasing the number of weekly sessions currently provided, in order to address waiting times and to provide improved access for patients."

The minister also said that Dr Herity recommended that some services be provided elsewhere but that in order to do this a number operational processes would have to first be embedded."

Mr Harris said he has asked his department "to address the implications of this recommendation by undertaking a national review of all primary PCI services with the aim to ensure that as many patients as possible have access on a 24/7 basis to safe and sustainable emergency interventions following a heart attack."

He said that he expects the review to be completed by the end of July 2017. 

Mr Harris said that Dr Herity recommended "new specialist equipment be provided in UHW to improve contingency for radiological equipment failure during a procedure." 

He said that the newly refurbished singular cath lab will "provide an additional 8 hours per week of procedures, which will allow for additional patients to be treated and will lead to fewer cancellations."

Moran broaches Alliance membership with independents

Independent Alliance TD Kevin Boxer Moran has said he had spoken to some independent TDs about joining the Alliance before the Dáil broke for the summer.

Mr Moran said he was still talking to independents as he said they want to recruit more councillors and also TDs.

Independent TD Mattie McGrath said he had been approached by the alliance weeks ago, although Noel Grealish said he had not been approached and would not be commenting further.

On the possibility of securing the support of other independent deputies, a spokesman for the Taoiseach said the matter does not arise.