The director of surgical affairs at the Royal College of Surgeons, Prof Arthur Tanner, has said that "for years" the RCSI has not recognised the Louth County Hospital, Dundalk, for the purpose of training junior doctors and "there is no way that in five weeks' time they can put structures in place to provide safe training".
Last week Prof Tanner wrote to the North Eastern Health Board warning that from January 1st, 2003, the hospital would not be recognised for training junior doctors who are not registered with the RCSI.
He made his comments on LMFM local radio, where he also confirmed that last year the health board was told it had 12 months to put structures in place to prevent this scenario.
The college says that at least two full-time consultant surgeons should be appointed at the hospital, one to general surgery and one to accident and emergency (A&E).
The health board confirmed it had been given financial clearance by the Department of Health and Children to fill two consultant surgeon posts at the hospital, and that "these posts will now go before a Comhairle na nOspidéal meeting in December for formal approval. It is hoped to fill these posts in a permanent capacity as soon as possible."
Until the posts are filled - and until the board can secure registered junior doctors for four more positions to become vacant on January 1st - the hospital is facing the effective cessation of general surgery and A&E services.
However, the board is hopeful it can fill the positions from a panel of registered doctors.
Meanwhile, concerns have also been raised about the future of A&E doctors in another health board hospital, Our Lady's, Navan, Co Meath. The Royal College of Surgeons, which has obligations to ensure proper training standards in the country's hospitals, has said it will only give temporary recognition to three junior doctor positions in Navan. This recognition will cease from June 30th, 2003, unless the health board appoints a fully trained and permanent emergency medicine consultant to the A&E department.
In a statement the health board said it had applied to the Department of Health for approval of an A&E consultant to be based in Drogheda and with sessional commitments to Our Lady's in Navan. It acknowledged there were difficulties over RCSI recognition in Navan.
If the situation is not addressed, Our Lady's would become the third NEHB hospital to find itself without accreditation from the RCSI. Negotiations are continuing to resolve a similar problem at Monaghan General Hospital, which is without recognition for junior doctors in anaesthetics.
The chief executive of the NEHB, Mr Paul Robinson, last month warned that this situation could arise. He also said the NEHB "has the most under-developed acute hospital services in the entire country".