The HSE published a report tonight into the re-organisation of acute hospital services in the Midwest region.
The report, which was seen by the Irish Timesduring the week, says that emergency department services need to be reconfigured as the present system is "unsustainable".
It says “prompt action” is needed to reduce the current levels of clinical risk and improve patient safety.
It recommends that round-the-clock AE services should be provided at only one hospital in the region – Mid-Western Regional Hospital in Limerick – which it says should be equipped with a helipad for emergency transfers.
The review also recommends centralising emergency general surgery, major elective surgery, elective orthopaedic surgery, critical care, coronary care and obstetrics at the Mid-Western Regional Hospital. It said this hospital should provide all specialist acute care for the region.
The review was carried out by Horwath Consulting Ireland Limited and Teamwork Management Services Limited.
Although the review was completed in December 2007, the HSE held off from publishing it until tonight. Last November Minister for Health Mary Harney indicated that the decision not to put its findings into the public domain was a deliberate one. She told the Oireachtas health committee that if the review conclusions were published before the HSE got "buy in" from staff, it might never get implemented and then the cost of the review would be money down the drain.