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That pot Kenny show on Newstalk. Now, have you ever tried to take a picture with an old digital camera or maybe a tell your 10 year old phone and then you look at the picture you've taken and it's a bit pixilated or blurry, and the photographs taken by your friends were the latest model and they're crystal clear.


But when it comes to CT scans and memories, that clarity becomes even more important than a simply the simple family snapshot.


So why are hospitals using outdated machinery and equipment just in case it is CEO of the Irish Medical and Surgical Trade Association and is on the line?


Gentlemen, good morning. Good morning.


What kind of machinery are we talking about?


The reports recently passed. We're those imaging equipment, which would be CT machines, traditionally called a CAT scan, MRI machines and imaging equipment. So the recent study recently was concentrating on those. But we're really talking about old equipment and hospitals, everything from operating theatre lights to theatre tables to and disinfecting machines, washing machines, every piece of equipment in a hospital. It is regulated. Yeah, some of some of it.


I mean, obviously, if the lights go out in an operating theatre, that's serious. But normally there would be a number of light sources have one filament goes. It might be a warning. Let's change all the filaments in at the operating theatre.


But there are other things that are much more critical. And I'm thinking of the diagnostic stuff.


I mean, if your scanner can't see what the new scanner can see that serious it is perhaps, you know, using the latest medical the latest imaging technology can reduce the necessity to confirm results by referring patients to additional imaging. For example, patients could have a diagnosis from a quality CT without having to have a confirmation by ultrasound or MRI. And that would reduce the cost of treating the patients, that would reduce the waiting times, and it would be faster diagnosis, leading to better outcomes for patients.


We feel that there's a significant public health risk exists from continuing to utilise ageing and obsolete equipment for the diagnosis and the treatments of disease in Ireland.


You reckon what hundreds of millions of euro need to be spent? I mean, what would you pay now for a good MRI scanner? Well, that's very substantially, but it would be a very substantial contribution, investment with the facilities, et cetera.


You're talking at least a million euro, I'm sure, a patch and an installed base of about 700 million euros worth of equipment that is due to be replaced probably on a rolling basis of about 70 million a year. That's the normal rule of thumb that you would have to keep the equipment safe. And up to date, that hasn't been happening since 2008. They've only been spending about the he has been investing or spending about 25 million a year. So there's a shortfall of about 45 million a year.


And over 10 years, that's a half a billion. Do we know to what extent claims made against hospitals derive from the fact that diagnosis was imperfect due to bad machinery?


Yes, there are some figures out there at the state claims agency, which is part of the National Treasury Management Agency. They published an important report in 2017 analyzing clinical incidents, claims and costs for the period for a five year period, 2010, 2014. And a significant finding was that the category failure, faulty medical device or equipment was the third most common clinical incident recorders. So they're paying out very significant amounts. And one example perhaps would be the estimated liability for maternity claims for birth specific procedures was over 12 million euro.


We should be investing in the equipment instead of paying out negative things.


I'm looking at some of the facts as outlined. South Tipperary General Hospital has a CT scanner whose end of life date was 2013 and its best before date was years. Before that, 10 more scanners end of life stage in 2017. Only six of the 58 scanners have funding allocated for replacement. And it goes on and on and on and on.


Now, people would say, well, actually, Justin, who's CEO of the Irish Medical and Surgical Trade Association, representing the people who flog this stuff, that you're just out to feather your members nests.


Oh, no, not topass industry wants to be a strong partner for the states, leveraging the experience and the commercial flexibility capabilities that we have to offer to support the health and well-being of our population. If they don't replace the equipment, its wear and tear, it's going to cease to be as effective as it was in the past. But for four to. And Professor Anthony Stain's, we've often had him on the program from D.C. School of Nursing. He said the figures, as outlined in these reports, are the tip of a devastating iceberg and part of a pattern of bad management.


And the Hajazi generally says imaging techniques improve over time. Older machines are not as good as modern machines with the images they produce or the speed at which they are produced. So that that's reiterating the point from a medical rather than the commercial side that we would be much more efficient. But there is the cost benefit analysis. The House will be thinking they're looking for hundreds of millions to do this and we'll, you know, save a few minutes on each scan.


Therefore, we can cram in extra scans per week. If we get the new machine, is it worth it?


They'll be asking those kind of questions. Well, but it's not about cost, really, it's about investing in the system and treating patients equipment efficiency was a fundamental principle, and depending on what a hospital wishes to achieve, they can oversee 20 percent more patients with the same time frame. Our staffing volumes are they can have a reduced cost of about 20 percent by investing in the equipment. You're right, modern equipment probably is about 20 percent more efficient at the very least than age and older equipment.


It'll be similar to your car, part of your driving 20, 20 year old car. You wouldn't have a lot of the facilities that are available. Are the safety of a car you'd buy today passed?


Yeah, but if I'm going to have to invest in, say, a new electric car, I'm going to have to invest 35 grand, whereas I can carry on with the existing car, have no capital cost.


You can see why people do it. Well, what if you took over a seven year period, which is the typical life cycle for equipment, the revenue budget of DHC is about 120 billion and the capital budget would be about 700 million. So that's a ratio of 160 to one. So the capital equipment isn't a huge cost plus quality or expensive individual item. The Department of Health in 2017 actually did a midterm.


OK, just we're losing your line. That's popping in and out, so we leave it there. Justin Carty, CEO of the Irish Medical and Surgical Trade Association. Thank you very much.