The Minister for Defence, Mr Smith, has insisted he backs the Hanly report on reform of the health services, despite the reservations he has expressed about the downgrading of the county hospital in Nenagh, Co Tipperary.
Speaking on RTE's Five Seven Liveradio programme, Mr Smith said those who lived in isolated areas, with poor roads and a long distance from services, should not be sacrificed on "the altar of the Hanly report".
However, he insisted that in taking this stance he was not in breach of the principle of collective Cabinet responsibility.
The Taoiseach, Mr Ahern, told the Dáil this morning that Mr Smith "totally accepts" the Hanly report.
"We are talking about a very serious report, the bulk of which I can support without any problem," he said.
"But there are implications in it which affect the county hospital in Nenagh, which I'm duty bound as a public representative to see can they be rectified in the interests of the public.
"Bear in mind, people are growing older. As they grow older, there are more problems up ahead for them. Many of them live alone, many of the roads in parts of my constituency are not too accessible and the distance to Limerick hospital can be too far so I want to make sure that the intermediate services available in the county hospital, in tandem with the report are kept up to the highest level possible. I see nothing wrong with that."
Mr Smith said it was his job, as both a minister and a TD, to "tease out" the issues involved to make sure the best possible services were provided for people. He said that view was "not cutting across cabinet responsibility or anything else".
He said a lot of the ambitions incorporated in the Hanly report, covering new areas and different disciplines in health for the region, were "tremendously welcome".
"There's no need to sacrifice the people who live in the outlying areas who are on poor roads and a long distance from services and who feel threatened or worried, no need to sacrifice them on the altar of the Hanly report."
Mr Smith said the worries of the "ordinary person" who gets a stroke or heart attack and who was a long distance from a hospital, even a long distance from Nenagh hospital, had to be taken into account. He said that was all he was doing and didn't expect his colleagues to do "any less or any more".
The Green Party leader, Mr Trevor Sargent, said in the Dáil today that "in a normal Government, Mr Smith's position would be untenable".
The Labour Party leader said this evening that the "latest intervention" by Mr Smith was "the most direct challenge yet to the authority of the Taoiseach".
"Having sat just a few seats away this morning as the Taoiseach assured the House that the minister totally supported government policy on the Hanly Report, Deputy Smith then took the earliest possible opportunity to give an interview to RTÉ making it clear that he most definitely did not support government policy in so far as it applied to his constituency," Mr Rabbitte said.
"Minister Smith seems keen to establish a new principle of government "NIMCY" - not in my constituency."
Mr Rabbitte said there had "never before in the history of the State been a Taoiseach of any party who has tolerated government colleagues thumbing their noses so blatantly at the office of the Taoiseach and the principle of collective cabinet responsibility