The surgical service at Cavan General Hospital has been under scrutiny since the death last month of a nine-year-old girl three weeks after she underwent an appendix operation.
While it is not yet known if her operation had anything to do with her death, the tragedy cast into the spotlight the difficulties which had arisen at Cavan General's surgery department in recent months, particularly since two of the unit's three permanent surgeons were suspended last August due to interpersonal difficulties. Then the unit's third surgeon was absent due to illness.
There followed a high turnover of locum consultant surgical staff and loss of sub-speciality skills. GPs in the Cavan and Monaghan areas were concerned about the lack of continuity in care which could be offered to patients attending the unit.
But it wasn't only they who were concerned about surgery in Cavan after Dr Pawan Rajpal and Dr William Joyce were suspended.
The board's own medical adviser, Dr Finbar Lennon, wrote to the North Eastern Health Board last September recommending that elective surgery be suspended. This did not happen.
He also warned that emergency surgery at the hospital could "only be safely delivered with a stable and consistent locum consultant surgical presence on site".
Now the health board will face stiff questioning from the families of 15 patients who were the subject of adverse clinical incidents, mainly surgical, at the hospital between September and December 2003, after Dr Lennon's warnings were issued.
Their concerns will have been heightened since the publication of a review of those 15 incidents on Thursday. The review was carried out by Dr Lennon, who made a number of crucial observations.
While they were all high-risk cases he felt it was likely one of the principal causes of the high number of adverse outcomes was "the inadequacies in the assessment and selection process for surgical interventions".
He also found there was an absence of clear surgical leadership at the hospital and said consideration should have been given at an early stage to transferring some of the patients to another hospital with specialist gastro-intestinal surgical services. He also criticised the lack of regular clinical audit meetings in the surgery unit.
Of the 15 patient case notes reviewed, all but two underwent surgery. Nine of the patients are now dead. Seven died within 30 days of surgery.
The health board has said it will implement Dr Lennon's recommendations. One of these refers to elective surgery, and Dr Lennon stressed that it was very important that the range and quantity of elective surgery be increased immediately in Cavan. The health board said it would do this "as far as possible".
The Taoiseach, Mr Ahern, told the Fianna Fáil Ardfheis last night the Government had set out plans for delivering "world class care".
If it comes it will be too late for the 15 families at the centre of this latest Cavan investigation.