Dr Colman Muldoon has been told he is no longer welcome at the hospital where he has spent most of his career. The 59-year-old consultant physician can now visit Our Lady of Lourdes Hospital in Drogheda only to collect his mail.

The chest specialist was last month suspended with pay from his £81,000 a year post amid management claims that he had created "chaos" and jeopardised the welfare of patients.

It is not claimed that Dr Muldoon harmed his patients but that he kept them in hospital for too long, thereby denying treatment to other patients and potential patients.

His case is deeply divisive and has pitted consultants in the hospital against each other, with some swearing affidavits against their former colleague while others join street protests and sign petitions for his reinstatement.

Dr Muldoon's vocal supporters say patient care is being sacrificed on the altar of a budget-centred health service. His detractors claim that his over-cautious discharge policy was damaging to other patients.

Dr Muldoon, a tall and lean man with thick greying hair, says he was upset, emotional and "a bit incredulous" when he was handed an envelope during an out-patient clinic notifying him that he was on immediate enforced paid leave.

He says the letter was the final stage of a six-year clash between him and the management over the length of hospital stay for his patients versus budgetary concerns. He claims he was harassed and bullied by the management and had his responsibilities gradually downgraded.

"If you don't believe what the doctor tells you is for your own good, you can't have any relationship with your doctor," he says, seated in the waiting room of his private surgery in Drogheda. "Doctors' decisions must be solely based on medical grounds and not influenced by financial or other constraints."

Dr Muldoon claims that 61 of the hospital's 360 beds were closed at the time he was suspended and that up to six patients frequently slept overnight on trollies. He says he made a formal complaint to management some six months ago after an elderly patient of his had died while awaiting an appointment.

Dr Muldoon says he kept his patients in bed for an average of 10.8 days - 2.1 days more than the hospital's average in the general medicine area. The North Eastern Health Board, which runs the hospital, could not confirm or deny Dr Muldoon's claim that the average length of bed stay of his two consultant physician colleagues was 8.5 days. The national average bed stay in all disciplines is 6.7 days, with the average for Our Lady of Lourdes at 5.8.

The board has said that between 1,000 and 1,600 additional patients could be treated annually if Dr Muldoon performed his duties "within the norms of his speciality".

The hospital has also been penalised for excessive length of stay by Department of Health fines totalling £1.2 million in the past six years.

Dr Muldoon tried unsuccessfully last month to get a High Court injunction against the board's move to place him on paid leave. Nine of the hospital's 22 fulltime and eight part-time consultants swore affidavits in support of the health board at that hearing. Dr Muldoon's legal challenge will continue in the High Court this year. His solicitor, Mr Robert Dore, says both parties have agreed to be bound by the findings of a peer review of Dr Muldoon's clinical practice by an independent group of doctors from the Royal College of Physicians.

A spokesman for the NEHB said it could not comment on Dr Muldoon's case while further legal action was pending but denied the doctor's claims that there have been cuts in services at the hospital. Since the board took over the hospital in 1997, staff numbers had increased and the annual budget rose from £22.3 million to £26 million at the end of 1999, he said. Currently, 31 beds in the day and gynaecological wards were closed due to the national shortage of nurses, he added.

Meanwhile, the representative body for hospital consultants is preparing to step into the fray. Dr Muldoon's case will top the agenda at today's monthly meeting of the Irish Hospital Consultants' Association's national council.

The IHCA is angered that the board justified its action against Dr Muldoon on the grounds that his behaviour breached a clause in the common contract issued to all hospital consultants.

The clause allows hospital management to place consultants on administrative leave with pay if their conduct "may be an immediate and serious risk to the safety, health or welfare of patients or staff".

Mr Finbar Fitzpatrick, the general secretary of the IHCA, says the thinking behind such a clause when it was negotiated three years ago was to give boards the power to remove staff who arrived into hospital "blind drunk or carrying a shotgun".

He says the board has "turned the clause on its head" by using it against a consultant who it claims has overused beds.

"If this clause is to be used like this, the independent clinical judgment of the consultant is completely eroded and consultants can be made to discharge their patients as quickly as is necessary to meet the needs of management," he says.

Mr Fitzpatrick claims the use of such a clause "relieves the health board of the obligation to open more beds and brings more and more to the fore a budget-centred hospital service."

He says there is "eternal potential for friction between consultants' clinical independence, where you want to do the best for your patients, and the administrators who say `my budget is limited'. It's difficult at the best of times to square that circle but other hospitals have done it."

In the hospital this week, nurses and doctors told The Irish Times that Dr Muldoon's case had caused anger and upset. One junior doctor who trained under him said Dr Muldoon was hard-working and diligent - the type of doctor she modelled herself on.

A short car journey away in his surgery waiting room in Fair Street, Dr Muldoon vowed to continue his legal battle to get his job back and said he was heartened by the public support he had received. "I am proud to be a doctor. I'm privileged to be able to help people but that brings obligations as well to treat people to the best of your ability - and you owe them that."