Hospital consultants are "aggravated" by the report on bed management. They said they have no intention of co-operating with one of its main recommendations which centres around the appointment of bed managers to oversee the admission and discharge of patients.
Mr Finbarr Fitzpatrick, general secretary of the Irish Hospital Consultants' Association, said consultants would not hand over their authority to admit and discharge patients to anybody else.
"We cannot do so because of the legal consequences. It won't work," he said.
He also defended consultants against criticisms levelled against them in the CAPITA report. Many consultants did ward rounds late in the day, he said, because they were busy with out-patient appointments or in theatre in the morning.
Furthermore, he said, if a consultant had up to 60 patients and began a ward round at 8 a.m., it could be 4 p.m. before the last patients were seen.
"It's still not too late in the day to discharge patients at that stage," he claimed. "A surgeon can't leave a patient wide open on a table and rush up to a ward to discharge somebody."
Referring to the report's assertion that some consultants visited patients only once a week, he said the report suggested they couldn't be bothered visiting their patients more often, when in fact in many cases consultants were attached to two different hospitals and it was in their contract that they visit one of the hospitals just one day a week.
"The report is shallow in that respect. It shows a total lack of understanding of the way consultants work. They seem to give the impression that consultants have nothing else to do other than ward rounds," Mr Fitzpatrick said.
He did not accept some consultants "held" patients in beds over the weekend to facilitate the admission of their own private patients on a Monday. He said whatever consultant was on call at the weekend would discharge patients if they were fit to go home, whether they were his/her own patients or not.
"There is no gain for consultants keeping patients in hospital longer than is necessary," he said.
He also stressed that if patients were discharged too quickly there was a danger they would have to be readmitted leading to "a revolving door system".
The Irish Medical Organisation, which represents 650 hospital consultants among its 5,700 members, also rejected criticisms of consultants in the report.
Its director of industrial relations, Mr Fintan Hourihan, said that rather than blaming overworked medical and nursing staff, the debate should seek to address solutions to the lack of beds, medical and nursing staff and the need to ensure patients are discharged without fear of rapid readmission.
The Irish Nurses' Organisation welcomed the report. Its deputy general secretary, Mr David Hughes, said its findings endorsed a ten point plan issued by the INO in February 2001 to address the ongoing crisis in A&E departments.
"The report makes many recommendations which are reasonable, practical and cost effective in the crisis management context within which the Irish acute hospitals are working. It will be a significant aid to those who wish to genuinely resolve those difficulties," he said.