Waterford stays optimistic in the face of years of neglect
A yearned-for out-of-hours cath lab remains a beacon of hope for southeast city
How do you describe Waterford?
It’s a summer evening after rain. In the middle of a warren of small streets up a hill stands Walsh Park, Waterford’s GAA stadium, where two local teams, De La Salle and Erin’s Own, are doing battle. It’s a perfect evening for hurling, calm, still, punctuated only by the music of ash striking leather.
Hurling defines Dunphy’s view of the city. Sometimes it’s a parish, sometimes it’s a school, sometimes it’s a big housing estate, but every neighbourhood has its own club.
“Look at the clubs in the city. De La Salle, Ballygunner, who are the powerhouse at the moment, Roanmore, Mount Sion, the strongest of them all with the likes of Jim Greene and the McGraths in the past.
“Then there are clubs like Ferrybank, St Saviour’s and Erin’s Own, all of them doing well in the county. Look at Erin’s Own, who we are playing tonight.
“A lot of players from different clubs grew up together and were friends. But the rivalry on the pitch is huge. Hurling is very, very important to Waterford. It’s a huge part of my life.”
How do you describe Waterford? Like any city there are countless ways. It’s Ireland’s oldest city, with an extraordinary Viking heritage. It’s the home of Waterford Crystal, which once employed 3,500 people. Its exquisite cut glass is still the city’s biggest tourism attraction.
It has a place strong in arts and drama, with Red Kettle and Spraoi, and a light operatic heritage. It’s where, for some strange reason, punk bands and mods have long had a strong foothold.
It’s the home of the distinctive bread roll, blaa, and also the place, and this may surprise, where the cream cracker and the rasher (through Henry Denny) were invented.
With a population of about 53,000, it’s a pleasant city, pedestrianised, with good motorway connections – blessed with a spectacular, often sunny coast lines. Ireland’s Florida.
Against all that, people have concentrated on the negative in recent years. The first thing noticed by visitors is that everything is on one bank of the Suir and the other is a desolate wasteland. That kind of lopsided quality defines the city – there is a sense that there is something about it that is unfinished or incomplete.
The figures bear that out. Waterford has the country’s second-highest number of unemployment blackspots, nine of them. It is second only to Limerick. Its unemployment rate is 9.3 per cent, lagging 3 per cent behind the national figure of 6.3 per cent.
Waterford Institute of Technology has yet to gain yearned- for university status. Less than 1 per cent of IDA jobs created between 2011 and 2016 went to Waterford. Many of the jobs that came were poorly paid.
There is a prevailing belief (expressed in varying degrees) that the city has been neglected, forgotten about, not given a fair crack of the whip.
Thirty years ago, Galway and Waterford were the same size. But the western capital has forged ahead, home to 80,000 people, while Waterford has largely stood still.
Galway has hoovered up a lot of high-tech foreign direct investment and gets 1.3 million tourists a year compared with Waterford’s annual numbers of a modest 263,000.
The biggest repository for that sense of grievance has been the thwarting of demands for a second catheterisation laboratory – a cath lab – for the region.
These are the labs where diagnostic imaging equipment is used to visualise the arteries and chambers of the heart and treat any abnormalities.
The city’s university hospital does have a cath lab, but it operates only from 9am to 5pm on weekdays. Patients in need of care outside office hours must be taken by ambulance to Cork or Dublin.
Recently a 40-year-old Waterford farmer, Tom Power, died in an ambulance on his way to Cork after suffering a heart attack. An out-of-hours cath lab in Waterford, arguably, could have saved his life.
Independent Minister of State John Halligan has essentially pinned his political career on this issue. For a Dublin-centric audience, it smacks of localism, of a Healy-Rae deal. But the campaign runs far deeper than that and has widespread community support.
“We are not trying to engage in this in a hysterical manner,” says businessman Matt Shanahan, founder of the Health Equality for the South East group. “There’s a fundamental inequality here that needs to be addressed.”
Halligan did make progress on it within Government. It culminated with an agreement that an independent cardiologist, Niall Herity, would conduct an independent review.
Halligan and all those who campaigned were confident it would finally cross the line. “I thought we were home and dry,” said Halligan. “When Simon [Harris, the Minister for Health] called me into his office to tell me that Herity had turned it down, I went white from shock.”
Halligan, Shanahan and others who had campaigned for so long on this issue struggled to understand why. They then discovered what they contend were flaws. The main one is the population base of 230,000 relied upon in the Herity report, which campaigners say was less than half of the true catchment in the region.
In addition, a HSE letter that Halligan got his hands on – heavily redacted – also strongly suggested the HSE emphasised very strongly when setting the terms of the report that a second cath lab was not a priority.
Rob Landers, clinical director of the South East Hospital group argues the catchment should have been closer to 600,000.
“Herity arrived at a population with a circular argument,” says Landers. “He defined it using the current throughput of work in the lab with the counties of origin of those who use it.
“He should have looked at the waiting lists of those who are not able to use the lab and have to go to Dublin and Cork. His methodology was fundamentally flawed.
“The population that would use a cath lab in Waterford should be defined by the 90- minute travel time to the lab. That encompasses the vast majority of the southeast.”
The lab that Waterford has is the most efficient in the State, but it operates during office- hours only and has a waiting list of 18 months. The case for a second lab is inarguable, say campaigners.
“The caseload is there and the population is there,” insists Landers.
Says Shanahan: “The political and economic discrimination shown to this region is evident in many metrics in common use. The healthcare component is especially disadvantaged as is clear in the case of regional cardiac services and also evidenced by the combined underfunding of the South East regional acute hospital network.”
Ray Griffin is a lecturer in strategy in WIT and an outspoken critic of what he sees as the Government’s indifference to the southeast and Waterford in particular. Health is just one area where he argues the data suggests a regional bias against the southeast. He is especially critical of the Herity report for using a UK report as the basis for calculating the threshold of cases that would justify a cath lab. Griffin argued the population density in the UK is four times that in Ireland. The time it takes to get to the nearest cath lab is critical, he argues, and should be the dominant factor.
“My work would indicate about 6.3 people will die per year in the southeast because of the absence of the service. The Thomas Power case was a symbolic case because he was a young man with no other issues. It’s only a matter of time before another case will emerge.”
As of now, there has been a promise of a temporary lab later this year, as well as a national review, agreed by Harris after a delegation of local politicians met him. Halligan almost resigned over this issue but now believes it will be fully delivered.
“I would be confident if there is justice and fair play that we will get it over the line for a 24/7 cath lab,” he says.
Griffin’s take on wider issues is interesting. Once known as the Ardkeen, the local hospital is now University Hospital Waterford – but the “university” refers to University College Cork, not to a local institution.
Asked if Waterford’s Institute of Technology could offer medicine as a course in the future, Griffin replies a little morosely: “The ambition of the city is crushed and it is no longer looking at that horizon.”
The problem is this: “Each generation of the middle classes clear out because of our limited higher education capacity.” While WIT has created an impressive 600 high-tech jobs through spin-off companies, under its head Willie Donnelly, Griffin says the southeast gets only 1.6 per cent of capital investment in higher education. Bright kids go to university elsewhere and most don’t return.
The latest southeast economic monitor produced by Griffin and two WIT colleagues shows that while employment has grown in the region, most of the jobs have been low-income and low-skill. There is little to hold on to the brightest.
Some ascribe it to the lack of political patronage. Martin Cullen was the last senior minister in Waterford and he is seen as partly responsible for the M9. Now the economic monitor report argues that the IDA underperforms in bringing jobs, while complaining that the level of activity by Enterprise Ireland is low too. The group also expresses concern that the cath lab controversy may send out a message that the hospital itself has been downgraded.
Another member of the hospital campaign group, retired civil servant Des Griffin, points to a myriad of reports on establishing a university dating from the 1930s to the present day. “How many more do we need to come out?”
Ray Griffin believes Waterford has been left behind because of a lack of political patronage. “Any discretionary activity you can think of the short straw comes here,” he says. “Cardiac care is incredibly symbolic of the region. It has revealed how politics has worked against us.”
There is consensus that the southeast is playing “catch-up”, as Shanahan describes it. Before he became a politician, Halligan worked on the docks and in shipping, as his father and grandfather had done. It employed hundreds. Other generations in the city worked for Waterford Crystal, which was to the city what Ford had been to Cork, with 3,500 working there at peak production. But those industries with their thousands of jobs died out and the city has struggled to replace them.
“The city depended for too long on too few companies,” says Paul Nolan, president of the chamber of commerce, not mincing his words. “Significant work has gone into changing that situation. While we are still lagging behind in unemployment, there has been a good improvement in job creation.
“Where we are concerned is the quality of the jobs and the relevance of the jobs going forward. It needs to be in innovation and the higher end of technology.”
That sentiment is shared among politicians from very different backgrounds.
Tramore-based People Before Profit representative Una Dunphy highlights long housing waiting lists and homelessness. She calls for major local authority schemes – she lives in a council house built in the 1950s.
“The PBP position is to push for a huge social housing build by local authorities.”
She makes a more general point: “We are not getting our proper piece of the pie. We have a lot of youth unemployment. We have a lot of unemployment blackspots. We have trouble with our hospital and trouble with our third level.”
Nolan and the chamber’s chief executive, Ger Hurley, outline a grand vision for the city that will see its population double to 100,000 by mid-century. Key to that will be a technological university, better infrastructure (including motorways) and a revived airport offering trips to the UK and beyond.
The development of tourism is a common theme for all speakers. There is resentment that the Copper Coast was excluded from the Wild Atlantic Way. Waterford Glass, the Viking Triangle and now a spectacular Greenway between Waterford and Dungarvan are the main planks of the local tourist trade. Most were brought about by locals, says Ray Griffin.
For Nolan and Hurley of the chamber, national investment is essential. “We are a bit like the dependent child now,” says Nolan. “We need a bit of support, but with subsidies we can lead for the region.”
Hurley gives an example of the ultra-ambitious Falcon Malls project on the north quays. It is now derelict, but a Saudi Arabian company proposes to invest hundreds of millions of euro in the project.
Waterford has little shopping space and attracts fewer tourists. However, the State would be required to invest €50 million in infrastructure. The return would be enormous, he contends (€3 billion over 12 years, though that sounds a tad optimistic). But then, the shopping mall would be enormous and employ 700 people.
Rather than targeting British tourists, the Saudi-backed project would focus more on US and “rest of world” tourists.
It sounds lofty but Hurley and others including Halligan think it can be done.
The Waterford Crystal factory and its shop are still the city’s top attractions but the tour buses leave the city as soon as the decanters and whiskey glasses are bought.
There is a big effort being made to make tourists’ experience of the southeast less fleeting.
Waterford is no longer in the nadir of 2012 when the news was unremittingly bad (Talk Talk leaving, Waterford Crystal in dire trouble).
Amid all the difficulties of recent years, hurling was one of the many things that kept a community going.
Back to Owen Dunphy, the De La Salle manager: “Over the past number of years, industry has been hit hard and we have suffered a lot with emigration. The county team have been going reasonably well over the years and we keep plugging away with the kids and hurling has been very important to us. It has made a huge difference.
So how do you describe Waterford? It is a city where there is optimism and hope, although it’s fitful and it is uneven. Still, there is a sense that its future is wrapped up in the outcome of the cath lab row.