Former minister for health Micheál Martin was warned nearly six years ago of inadequate cancer services at the Midland Regional Hospital in Portlaoise, it has emerged.
Consultant surgeon Peter Naughton, a specialist in breast disease, wrote to Mr Martin telling him there had been no progress in creating a breast cancer unit in Portlaoise a year after its approval.
Fine Gael health spokesman Dr James Reilly said the letter showed that assurances from Minister for Health Mary Harney that her predecessor Mr Martin had not been sent a warning about cancer services in Portlaoise were false.
The contents of the letter were revealed at an Oireachtas committee hearing on the issue this morning.
Mr Naughton also wrote to Ms Harney in 2005 saying cancer services at the hospital were a "shambles". She denied having read the letter until it became public in the wake of the controversy over misdiagnoses at Portlaoise.
Ms Harney and Health Service Executive chief executive Prof Brendan Drumm appeared before the committee to face questions over their handling of the Portlaoise cancer controversy today.
Three reports published yesterday were highly critical of the management of the service after nine women were wrongly given the all-clear for breast cancer.
Mr Naughton's letter of April 2002 to Mr Martin said: "Services for cancer patients are worse now than they were seven years ago . . . I am writing out of a deep sense of frustration and despair."
The letter said no one had been recruited to head cancer services at the hospital, £500,000 allocated a year previously had not been made available, and the posts of consultant radiologist, histopathologist, and a second breast disease specialist had not been advertised.
"As you can see, from the above, none of the core personnel, surgeons, radiologists or pathologists are in place," Mr Naughton said.
No provision for outsourcing services not available at the hospital had been made despite a request two years previously, and there was a three-month waiting list for mammography at the time, the letter said.
Dr Reilly said Mr Martin and Ms Harney must answer questions to the Dáil in the wake of today's revelation. Why the letter was not available under the Freedom of Information Act should be explained, he said.
"The question that must now be answered is: If the warnings that were flagged up had been acted on, would the misdiagnosis scandal that happened in Portlaoise have come to pass?"
Labour Party leader Eamon Gilmore said responsibility "for the shocking deficiencies in the cancer service in Portlaoise", lie with both Ms Harney and Mr Martin. It was "difficult to believe" that the letter had not been sent to Mr Martin for consideration, he said.
"Unfortunately Micheál Martin has a track record as Minister for Health for failing to read documents and briefs. His failure to act on documents warning him that the then regime of nursing home charges was illegal ended up cost the taxpayer tens of millions of Euro.
"In this case his failure to act on the warning from Mr Naughton may well have endangered the health and even the lives of women in the midlands," Mr Gilmore said.
There was an outcry last November when John O'Brien of the HSE National Hospital's Office told an Oireachtas health committee that Mr Naughton had began a review of ultrasound scans.
Ms Harney, chief executive of the Health Service Executive Prof Brendan Drumm and the patients were unaware of the review.