GENERAL PRACTITIONERS in the northeast who operate an out-of-hours service have told the HSE they will not co-operate with proposals that would see them providing emergency care after 8pm in parts of the region.
They also said they would relocate their Co Meath headquarters to ensure people in need of emergency care do not present to their service because it would be unsafe for GPs to handle such cases.
The HSE proposal is part of a wider plan to reconfigure hospital services in the northeast.
North East Doctor on Call Ltd (Nedoc) said yesterday the HSE would receive a letter by today stating that it would not co-operate with the new system because it would put patients at risk.
The HSE plans to close the A&E unit at Navan hospital and replace it with a minor injury unit. A&E units would remain only in Drogheda and Cavan.
The HSE has asked Nedoc if it would provide cover after the minor injury unit in Navan closes at 8pm.
Nedoc has its headquarters on the grounds of Our Lady's Hospital in Navan but the chairman of Nedoc, Dr Peter Wahlrab, said yesterday it would move to a different town if the A&E unit at the hospital closes.
He said: "It would be unsafe for Nedoc to take over the role of the minor injury specialist when there is no sign of any of the necessary structures in place to support that role." He said GPs "are not experts in trauma or emergency medicine - that is what the A&E is for".
GPs who work in Nedoc met over recent days and it was decided to inform the HSE it would not co-operate.
Dr Wahlrab said the 2006 Teamwork report, commissioned by the HSE and which recommended the reconfiguration of hospital services in the northeast, had recommended a range of support structures to compensate for the closure of A&E units at Navan, Dundalk and Monaghan.
He said that in its implementation plans the HSE had "only taken those changes that suit them - the elements that are cost-saving".
Dr Wahlrab said that for Nedoc to co-operate, the HSE would have to implement the Teamwork report in full, which would include a medical assessment unit, emergency medical technicians or paramedics, upgraded services in the A&E unit in Drogheda and functioning primary care teams.
He said GPs were already being called to emergencies that they were not trained to deal with such as car accidents, industrial accidents and accidents in the home. GPs were angry, he said, that the HSE was putting patients at risk.