The Midland Health Board has strongly rejected an assertion that the organisation of its hospital services is a "tragedy".
Last week, Prof Muiris FitzGerald, UCD dean of medicine and consultant physician at St Vincent's Hospital, Dublin, said the midland region was not being best served by running the three "co-equal" hospitals in Portlaoise, Tullamore and Mullingar for a population of 220,000 people.
Because inadequate resources had to focus on providing general services, expertise in specific disciplines was not being built up in areas such as the midlands, he said.Pairs of surgeons were appointed and had to to cover "everything".
"They also have to cover 365 days of the year. They don't have major linkages with the other hospitals. As a result, a team of six to eight surgeons cannot develop a sub-speciality orientation so when anything complex occurs, it's off to Dublin, Cork or Galway."
Prof FitzGerald was speaking at a Foundation for Fiscal Studies conference in Dublin. "It is a tragedy, I think, for the Midland Health Board with three co-equal hospitals all fighting for parity, wanting to be all-singing, all-dancing hospitals and then when anything complex comes along, everybody loses out," he said.
A Midland Health Board spokeswoman said major progress had been made in the region in recent years and it was "just not true" to say that specialist services had not been regionalised.
As far back as 1966, the need for the board's hospitals to function as a single integrated division working from the three sites was highlighted in the Sheffield School of Health and Related Research report, she said.
Specialist orthopaedic and ENT services were being provided in Tullamore while paediatrics and obstetrics had been regionalised to Mullingar and Portlaoise. Meanwhile, the Tullamore hospital had been designated as the lead centre for cancer services.
The spokeswoman said more recent decisions on regionalisation included a regional dialysis unit and a regional cardiology unit for the Tullamore hospital.
Prof FitzGerald had referred to the "county jersey" syndrome, where counties were pitting themselves against each other in the fight for facilities. "There is nothing new in the 'county jersey' quote," the spokeswoman said. "Indeed the analogy has been quoted at meetings of the Midland Health Board and it is the board's wish that it should be in the premiership of hospital services."
She said the health board clearly recognised that there must be a structured and strategic approach to the development of hospital services and regionalisation was evidence of this.
At the June 2001 board meeting, members called for a strategic approach to the development of hospital services in the region and signed up to a policy "which would contribute significantly to the development of hospital services in the board's area", she said. "An agreed policy on the distribution and organisation of medical and surgical specialities in the region was, therefore, urgently required."
Since then, the health board had been examining its approach to governance and this process would continue, the spokeswoman said.
"The Midland Health Board, at the request of the members, is preparing a master plan for the development of hospital services in the region."
In his address, Prof FitzGerald called for the removal of politics from the hospital system and said politicians must be indoctrinated, post-election, of the need for reform. Otherwise, the regions would lose out, he said.