Shake-up a huge challenge says Martin

The Minister for Health, Mr Martin, has admitted he and the Government face a "a huge political challenge" in garnering support for the proposals contained in the Hanly report, published today.

Mr Martin said he was committed to the report's recommendations which seeks to reorganise acute hospitals around regional centres of excellence and double the number of consultants from 1,700 to 3,600 by 2013.

It is the former that is the most contentious at local level with many residents living close to local hospitals reluctant to see Accident and Emergency units and maternity wards relocated to regional centres of excellence.

He said a "a formal Government decision" has been taken endorsing the report's recommendations.

Mr Martin rejected suggestions that proposals in the report would lead to the "stripping" of accident and emergency units and maternity services from local hospitals.

"We are not stripping local services from hospitals, I don't know how many more times I will have to say that. We are reorganising services but we are not stripping services. We are going to do things better. More organised and better for the patient out there.

"If you talk about the increase in consultant numbers it is a far better service for people in the regions. Instead of people having to travel to Dublin to see a rheumatologist or a dermatologist they will have access to facilities in the region. "

"People need to look at the big picture and the wider issue. I would like to think that if you were in trouble at 2 o'clock in the morning you would have access to the best quality care. I would like to see a senior clinical decision maker if I am in a bit of trouble in 2 o'clock in the morning."

However, with the Government under pressure on a number of fronts and local elections scheduled next year the Minister admitted the proposals in today's report could mean trouble for some of his party colleagues.

"I am under no illusions that this is very politically very challenging. It can be manipulated to the advantage of those who want to manipulate it. And equally it can be to the disadvantage of some of my [Fianna Fail] colleagues in particular areas.

However, the Minister urged those who believed in the report to articulate their support. "We are going to have to fight the fight politically and argue the case."

And he challenged critics of the report many of whom broke cover this evening to put forward a workable alternative.