Medical Correspondent Dr Muiris Houston examines the case for a neurosurgical facility in the west
Now is a good time to debate neurosurgical services in the west of Ireland, with the Hanly report on medical staffing due to be published and a formal review of the speciality under way at Comhairle na nOspidéal.
Indeed, there are valid arguments for and against providing a neurosurgical service at University College Hospital, Galway.
On the plus side, it is obvious that the reconfiguration of our hospitals will lead to three major centres of care in the Republic - Dublin, Cork and Galway.
With the exception of rare procedures such as transplants, these hubs should be in a position to offer some elements of highly specialised care to patients.
Just as Galway will soon be offering a regional radiotherapy service, it should also be offering cardiac surgery to people in the West.
And although the neurosurgery numbers would not be in the same league, geographical circumstances and the needs of the critically ill represent the key reason why a dedicated neurosurgery unit merits serious consideration.
There are geographic similarities between the west of Ireland and regional neurosurgical units in Dundee, Scotland and in Tromso, Norway. Providing a service for between 500,000 and 600,000 patients, their catchment population is similar. But perhaps even more persuasive are the surgical needs of isolated populations on exposed seaboards of Europe.
Those against a Galway unit say a proper helicopter emergency medical service is enough to ensure patients are rapidly transported to Dublin. There are also genuine concerns about the ability of consultants in the western unit to maintain increasingly specialised skills required as neurosurgery becomes more extensive and complex.
On balance, the argument in favour of having a unit in Galway probably outweighs that against. If the western capital is to function as a true regional centre, as envisaged in the soon-to-be published Hanly report, then it needs, as a minimum, to provide emergency neurosurgical services backed by a spinal unit.