A complete reorganisation of health services in the northeast is to be announced by the Health Service Executive (HSE) today. The HSE's aim, it says, is to improve patient safety by centralising certain services.
There are fears in Monaghan, Navan and Dundalk in particular that local hospitals will be downgraded.
The HSE's plan has been devised following a review by outside consultants of acute hospital services in the northeast. The review was carried out by Teamwork Management Services and its report, entitled Improving Safety and Achieving Better Standards: An action plan for health services in the North East, recommends a brand new hospital be built in the region.
The report has not said where this hospital should be, but the proposal is that major specialist services for the region would be centralised at this hospital, allowing greater sharing of expertise within the region and greater teamworking.
The region already has five acute hospitals - Our Lady of Lourdes Hospital in Drogheda, Cavan General Hospital, Monaghan General Hospital, Our Lady's Hospital in Navan and the Louth County Hospital in Dundalk.
The report from the review group, which is also to be published today, is understood to raise concerns about patient safety as a result of the manner in which certain services are currently being delivered at small stand-alone hospitals like Monaghan and Navan.
The terms of reference for the review included determining, with reference to international best practice, the optimal configuration of hospital services and consultant staffing for the geographic area and population of the northeast in order to provide safe, sustainable, cost-effective and high quality services.
The consultants were also asked to evaluate the benefits and risks associated with current provision of acute hospital services on five sites in the region serving a population of approximately 350,000 people.
The HSE said the report provided a detailed assessment of hospital services and a future direction for health services in the region.
The review was commissioned in the wake of the outcry last October when Patrick Joseph Walsh (75) bled to death in Monaghan General Hospital. He required emergency surgery on a bleeding ulcer but could not be operated on in Monaghan as surgeons there are not permitted to do emergency surgery.
Staff attempted to transfer him to three other hospitals - Cavan, Drogheda and Beaumont in Dublin - but were told none of these had an intensive-care bed available, which he would require after his operation. It transpired after his death that all three hospitals had vacant intensive-care beds.
An inquiry was ordered and its final report is now with the HSE and is expected also to be published shortly.
The HSE has organised a series of meetings for today to brief the medical boards of the five hospitals in the northeast, local politicians, GPs and other hospital staff, as well as the media, on its plans for reconfiguring services.
Prof Brendan Drumm, chief executive of the HSE, has argued that quality and safety of care for patients has to be put first.
After the death of Mr Walsh, he said: "I would challenge anybody in the political or the health system to produce for me any group of experts at an international level who are not tied down by the local politics of this issue to state that we should be maintaining five acute services across a population of 300,000.
"If people are saying that, I'm saying that that is not in the best interests of patients."