Plans by the Health Service Executive to have surgeons in Cavan General Hospital visiting Monaghan General Hospital to provide day surgery five days a week have been held up.
The plan was due to come into effect on January 1st but it has emerged no agreement was reached with three permanent surgeons in Cavan on them travelling to Monaghan one day each a week.
Finbarr Fitzpatrick of the Irish Hospital Consultants Association confirmed yesterday the change had not been agreed with surgeons in Cavan, who have been on the staff of the hospital for some time. "It can't happen without agreement with them," he said.
It is understood however, that the new arrangement has been agreed with two new surgeons who have just taken up posts in Cavan.
The HSE's plan to have all-day surgery provided in Monaghan hospital and all emergency and major elective surgery for the region carried out in Cavan from the beginning of this year was announced last November.
It met with stiff opposition, particularly in Monaghan where locals saw it as a further downgrading of their hospital, which has also lost maternity services in recent years.
It has also been claimed that no secretarial support has been put in place for the new surgeons appointed to Cavan and that additional anaesthetists will need to be appointed to work alongside them, but that this has not yet happened.
Mr Fitzpatrick said it happened all the time that consultants were appointed without the necessary supports being also put in place.
A spokeswoman for the HSE North East Area confirmed two new surgeons had taken up duty in Cavan and that "arrangements are currently being put in place to facilitate the establishment of a full surgical service, including increasing anaesthetic cover". She added: "Administrative support is in place for the new consultant surgeons."
She said the HSE was not aware of a problem regarding the existing surgeons in Cavan going to Monaghan daily.
Sinn Féin Cavan-Monaghan TD Caoimhghín Ó Caoláin said he was concerned about further downgrading of Monaghan hospital following comments from the manager of the north east hospital network on local radio yesterday. Chris Lyons was unable to confirm the future retention of medical services at the hospital, Mr Ó Caoláin said.
The hospital is still on call for medical emergencies such as heart attacks but Mr Lyons could not say if this would continue.
Mr Ó Caoláin also claimed beds had been closed in Monaghan following the transfer of most surgery to Cavan hospital at a time when patients were lying on trolleys in Cavan. The Irish Nurses Organisation said 20 patients were on trolleys in A&E at Cavan yesterday.
Seán McKiernan, a member of the Fine Gael national executive in the area, said without a major investment in beds and other health infrastructure in the region, there would be severe congestion in Cavan hospital, possibly leading to needless deaths.