Background: The people of Monaghan have been campaigning for years for the retention of certain services at their local hospital.
As far back as 1984 they organised themselves to mount a High Court challenge when the then minister for health, Barry Desmond, threatened to discontinue obstetric, gynaecology and paediatric services at Monaghan General Hospital after a decision was taken to build a new general hospital in Cavan.
The High Court at that time held that the services could be withdrawn, but the Supreme Court subsequently ruled that the minister, in proposing the closures, had acted outside his powers.
In the years since then locals have continued their fight for the retention of services, though they have lost a number of battles. They lost maternity services in 2001 and few will forget the uproar that caused when, as a consequence a young woman, Denise Livingstone, was turned away from the hospital in 2002 in an advanced stage of labour and ended up giving birth to a premature baby girl in an ambulance as she was being transferred to Cavan hospital. The baby died within hours.
Emergency surgery was also subsequently removed and locals say if this service hadn't been taken away the life of Pat Joe Walsh, a semi-retired farmer who bled to death at the hospital almost a year ago, might have been saved. He required emergency surgery and doctors attempted to transfer him to three other hospitals for his operation, but none of them would accept him, citing a lack of intensive care beds. It subsequently transpired at least two of the hospitals - Cavan and Our Lady of Lourdes in Drogheda - had beds free.
The anger which Mr Walsh's death generated in the local community was immense, but the fury which has been caused by the recommendations of an independent inquiry into his death has resulted in locals taking to the streets in their thousands to protest like never before.
The Walsh report, published earlier this month, recommended all acute inpatient services "be suspended as soon as is practically possible" from Monaghan hospital.
It also said five significantly sized hospitals in the northeast were too many and suggested Monaghan could be re-developed as a diagnostics and day care centre, with a nurse-led minor injuries unit. And, painfully for the locals, it "strongly recommended that it ceases to use the word hospital in its title". The Health Service Executive has said it will be implementing the report in the interests of patient safety.
The people of Monaghan say they will not stand for it. They have already elected a hospital candidate in the Independent TD Paudge Connolly and are threatening to run others next time.
But whether their protests and the mounting of a political campaign can reverse the decision of the HSE remains to be seen. The head of the HSE Prof Brendan Drumm has said there is no room for politics in healthcare and that his decisions will be based on patient safety issues only.