The Opposition last night reacted with scorn to the health service reforms recommended by the Hanly Report, warning that it will lead to the downgrading of local hospitals and poorer services.
"It is the worst kind of report. It simply cannot be done. It offers no realistic solutions on how to handle a pending crisis in the service. It answers no questions and solves no problems," said Fine Gael TD, Ms Olivia Mitchell.
The Department of Health has commissioned 148 reports over the last five years, she said: "The only thing currently growing quicker than the waiting lists is the publications list of the Department."
In particular, Fine Gael opposed cutting the numbers of hospitals with full-scale accident and emergency units from 40 to 12.
"It is not equitable, it is not safe and is not acceptable," said Ms Mitchell, the party's health spokeswoman.
"This plan is in essence an experiment. It is an experiment in health-service delivery. If they get it wrong, people suffer and people die. Therefore, we cannot simply abandon the old and plunge headlong into a new, untried and untested system.
"For the equitable delivery of most specialties, regionalisation and concentration are both necessary and desirable but this is not always true for A&E services, where in some instances proximity can be crucial to survival."
Regional hospitals would need an extra 2,500 beds to replace emergency beds lost in local hospitals, while large sums of money would be needed to boost the skills of general practitioners.
Major spending would also be needed for the ambulance service, particularly to bring all ambulance staff up to paramedic standards, while a countrywide air ambulance service would also be needed to transfer patients safely to the biggest hospitals.
The Labour Party's deputy leader, Ms Liz McManus, said the Government's decision to set up new committees would "be greeted with disappointment and dismay" by health workers and patients.
The latest report comes in the wake of Prof Niamh Brennan's decision to criticise the Department of Health's failure so far to act on the recommendations contained in her own report, published four months ago.
"This provides further evidence that the Fianna Fáil/PD administration is gripped by indecision and political paralysis when it comes to the health service," said Deputy McManus.
The Minister for Health, Mr Martin, is seeking to delay the reform of local hospitals until after next year's local and European elections.
"Further delays are not in the interest of the health service," said the Labour TD.
The recommendation to double the number of consultants and cut the hours worked by junior doctors was welcome, she said, but she noted that there was "no additional money whatsoever" announced alongside the Hanly Report.
Independent Wexford TD, Dr Liam Twomey, said nothing could happen until the consultants' contract is renegotiated. "You can't move until that has been done," he told The Irish Times.
Local communities are being asked to accept cuts in services now on the promise that they will get better diagnostic and other equipment later on.
"Surely they should have that first," Dr Twomey said.
Mr Cillian Twomey, a consultant from Cork University Hospital, was the only front-line doctor involved at yesterday's launch, he said.
A Sinn Féin TD, Mr Caoimhghín Ó Caoláin TD, said Hanly "failed to challenge" the hospital consultants' exploitation of the two-tier system. "It is a blueprint for centralisation and for loss of services at local hospitals."
The public has already seen the effects of local hospital cutbacks, particularly with the closure of A&E and maternity services at hospitals in Monaghan and Dundalk, he said.
"I know the reality of the pain that that causes to people. Hanly is that blueprint for over-centralisation and communities will suffer as a result," said the Cavan/Monaghan TD.
The Green Party chairman, Mr John Gormley TD, said the Minister for Health would find it "extremely difficult" to negotiate a new contract for consultants and he would face "stiff opposition from local communities".
The Minister for Health's protestations "will do nothing to convince people that their local hospital will not be downgraded", while the Minister for Finance, Mr McCreevy, must also be convinced to fund his plans, said Mr Gormley.
