The Eastern Health Board is negotiating the purchase of the Meath Hospital with the board of the hospital in order to establish a medical facility in the area when the Meath, Adelaide and National Children's hospitals move to Tallaght next year. However, local campaigners are concerned that a drug treatment centre will be put on the site.
Over 9,000 signatures have been collected by the Hospital Action Group in support of a campaign to retain a hospital in Dublin's south inner city following the move of the three hospitals there at the moment. These hospitals are being merged to form the core of the new hospital in Tallaght.
The population projections in the Fitzgerald Report, on which the plan for the Tallaght hospital was based, were made in the mid1970s, the spokeswoman for the group pointed out. Mrs Frances O'Leary said that these projections assumed a fall in the population of the inner city, while over the past number of years, with tax incentives for housing in the city centre and the development of local authority housing, the opposite has been happening.
"Ten hospitals in the city centre have closed in the past 10 years," she said. "There isn't even a direct bus to Tallaght from here. For example, I know of an elderly patient who has a specific treatment in the Meath every week. It would cost her £14 a week in taxis to go to Tallaght."
A spokeswoman for the EHB said that it had asked a working group to carry out a survey of the primary care needs in the south inner city. This recommended the establishment of a primary care centre, and the enhancement of general practice and community care services in the area.
The report recommended that such a centre should include "some or all" of the following services: minor injuries unit; out of hours on-call centre; paramedical services; day care procedural unit; a day centre for the elderly; public health nursing facilities; specialist facilities for general practice, and community services. It recommended in-patient beds for respite care, palliative care and stepdown care, and links with both Tallaght and St James's hospitals.
It also recommended that the medical input for running such a service should be negotiated with "a large and committed group of general practitioners from the area, using a roster system . . . Its advantages include the shift from expensive hospital-based care to a long-term commitment to community care, which reflects its multi-disciplinary nature," the report said.
Funding for the proposed services would come from development funds for the general practitioners' service, child care services and services for the elderly, mentally ill and women's health/family planning, and it says that significant additional funding would be necessary. However, in the summary of the report there is no reference to a possible location for the primary care centre. Nor are there any proposals about who would run it or what medical staff, other than input from local GPs, it would have.
The Hospital Action Group is concerned that a drug addiction centre would be put on the same site as the proposed primary care centre. "It would not be suitable to mix elderly patients and addicts," said Mrs O'Leary.
However, the EHB spokeswoman said she was not aware of any such proposal. "If we buy the Meath Hospital its future use would depend on the needs of the area," she said. "We may not even get it. If we do it would be planned to put a number of services there. The Meath Hospital is a very large site. You can take it we would aim to meet any needs thrown up by the survey."
Mrs O'Leary was also concerned about the existing proposals from the working party. "There is no X-ray provision, which is essential, and if there is a unit with in-patient beds, who will look after it?"
She said that in England there was a growing realisation that the strategy of concentrating all hospital services in a few very large hospitals was a mistake, and a move back to cottage-type hospitals, which were especially suitable for the elderly. "If they don't keep a hospital open they will have to build one in 10 years' time.
"If the hospitals (the Meath, Adelaide and National Children's) come up for sale in the spring there will have to be a structure put in place and there will have to be local input."