Background: Almost all of the five acute hospitals in the northeast have been at the centre of controversy in recent years. These revolved in the main around poor patient outcomes and even in patient deaths.
Among the most high profile of these was the death of nine-year-old Frances Sheridan three weeks after an appendix operation at Cavan General Hospital in 2004. A postmortem found she died from complications of recent surgery.
There was also the death last year of a 31-year-old teacher during a routine operation on her back at Our Lady's Hospital, Navan. And last October Pat Joe Walsh (75) bled to death at Monaghan General Hospital after staff claimed two other hospitals in the region - Cavan and Our Lady of Lourdes Hospital in Drogheda - refused to accept his transfer for emergency surgery.
A raft of reports have been prepared on adverse clinical incidents in the northeast and on what should be done to prevent other patients being put at risk but following the public outcry over Mr Walsh's death the Health Service Executive ordered a complete review of acute hospital services in the region.
Its report, published yesterday, worryingly says that patients continue to be put at risk - regardless of previous recommendations - as a result of the manner in which hospital services are configured in the region.
It makes the well-worn argument that the "low level" of clinical activity in each of the hospitals does not provide the necessary critical mass required to ensure best patient outcomes. Services are spread too thinly across too many sites and in many cases unsupervised junior doctors provide services, it says.
The blueprint it has devised to make the system safer will not go down well as it proposes that existing A&E units move to a major new hospital, yet to be built, and that existing hospitals retain only minor injury units. The report sets out clearly the arguments for doing this and the HSE said no services would change until the new hospital was in place and ambulance personnel and other staff upskilled.
The report has a ring of Hanly about it but whether this version can be implemented with an election pending hinges on staff and the public buying into it.