After sustained political controversy over the Hanly report on health reform, the Department of Health's chief medical officer yesterday commended the report and said there was no viable alternative.
Dr Jim Kiely said his decision to hold a press briefing to defend the report at this time was not related to the controversy surrounding the decision of the Defence Minister Mr Smith to express reservations about what the report planned for his local hospital in Nenagh.
"You say this is in response to other activities out there. I'm constantly putting statements and answering questions and doing interviews about a whole range of things.
"This is a really important development in the acute hospital system and in the wider hospital system and it would be remiss of me, in whatever circumstances there were, not to put forward a statement like this giving my professional view on how the system should develop. So this is not related to anything else."
He said implementation of the Hanly report in parallel with other developments in the pipeline, including increased bed capacity and appropriate resourcing of the ambulance service, as well as developing important elements of primary care, would mean people would have access to the health system where and how they wanted it.
"They will be the recipient of care delivered by doctors who are trained appropriately."
The hospital system was over-dependent on junior doctors in training, he added.
"It will ensure that patients, wherever they live and wherever they come into contact with the services, they will have access to high quality and safe and effective services."
Furthermore, he said, the report looked at present facilities, their volumes of activity and the medical expertise required to provide best possible services for patients. The report's principles were based on international and local experience. "It's simply not people off the top of their heads coming to the conclusion that this, that or the other is the way forward.
"No other analysis of these issues has been as fundamental and thorough, no other analysis has been based on such a wide and intense consultation and certainly no viable alternative has been advanced.".
It was for others to decide when, where and how the funding to back the report was delivered, he said.
A number of other doctors, including some staff at Ennis and Nenagh hospitals where, under Hanly, A&E departments will be reduced to minor injury units open from about 8 a.m. to 8 p.m., have expressed reservations about the report.
Dr Kiely, who advises the Minister for Health, said a lot of senior doctors were also part of the team that compiled the Hanly report. He said a process of education and information was now taking place and he hoped by the end of it the "resistance or fear" of the report would be removed.
Membership of the national Hanly implementation group is to be announced within days. So, too, is membership of the project groups to be set up in each of the two pilot areas.
These will have independent chairpersons and will decide which specialities go in which hospitals in each region. Local TDs will be able to make submissions to the groups but will not be included among their membership, a Department of Health spokeswoman said.
Fianna Fáil's Sen Terry Leyden has reiterated his public opposition to the report.
Speaking before a public meeting last night on the future of Roscommon Hospital, he said there were concerns that the second stage of the Hanly review could have a negative impact on future services at the hospital.