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Cardiologists at the Southern District Health Board are required to cover a service for which they are not qualified, the senior doctors' union says.
The Association of Salaried Medical Specialists has released a report from a joint meeting with board management this month, in which the lack of an echocardiology service was raised.
Echocardiology uses ultrasound to diagnose and manage heart conditions.
The health board's sole echocardiologist, who worked a half-time position, left the board several months ago and has not been replaced yet.
''Thousands of cardiograms needed to be reported and staff did not have the time, qualifications or skills to do this work,'' the report said.
Union representatives were told the board had spent a ''significant amount of money'' on cardiology, and its options were limited.
''The cardiologists present at the meeting expressed great concern about the situation, and the potential implications both for patient safety and for senior doctors.
''They noted that two years of training in a specific fellowship programme were required in order to read echocardiograms,'' the report said.
The union has also written to chief executive Carole Heatly asking for action.
Patient services medical director Dick Bunton, in a response yesterday, said the board was recruiting to fill the 0.5 full-time-equivalent position.
He said cardiologists were trained to perform echocardiograms in their specialist training. If required in complex cases, a review by an echocardiologist could be obtained.
''We believe the current service is safe, but are always reviewing and improving our practices.
"We are looking at how we can improve the current service, and are in discussion about the best way to do this,'' Mr Bunton said.