The chairman and chief executive officer of the North Eastern Health Board have both said the board does not have the power to place Monaghan General Hospital back "on call" and that that decision can only be taken on clinical advice.
Since July the hospital has been unable to secure accreditation for junior doctors in anesthetics, resulting in it being taken off call for emergency ambulance calls.
There has been a knock-on effect on the surgical and other medical services it can provide, with patients being treated at other hospitals in the region.
Close to 300 people from the Monaghan Community Alliance protested outside this month's health board meeting before being allowed to send in a deputation for a five-minute meeting.
Its spokesman, Mr Peader McMahon, said the alliance was established to restore basic services. "We demand acute and emergency medical and surgical, accident and emergency, gynaecological and other services to bring the volume and variety of work to a level acceptable to the professional bodies for the provision of staff and insurance."
He also said independent medical advice claimed that the other health board hospitals were too far from Monaghan to offer treatment in emergencies in a reasonable or safe period of time.
During a lengthy debate on the matter the CEO, Mr Paul Robinson, said: "I took the hospital off call on the basis of medical advice. I was requested by consultants in Monaghan to take it off call in the interests of safety."
While the board has the responsibility of providing health services it must take account of the professional bodies that set standards and training requirements in the area.
In this case the Royal College of Anaesthetists will not accredit Monaghan General Hospital for training.
The role of an outside body, this time Comhairle na nOspideal, was also referred to by the CEO in relation to the suspension of maternity services at the hospital over a year ago.
At that point the board passed a motion mandating the CEO to secure sufficient consultants to ensure the maternity unit reopened.
"The Minister for Health indicated he would give clearance and recommend the posts be approved, and proposals were submitted to Comhairle na nOspideal.
"It set up a group to look at obstetric and gynaecological services and it has still to report," Mr Robinson said.
Proposals by him to resolve the situation at Monaghan Hospital were rejected by the medical board at the hospital last week.
At the health board meeting its chairman, Mr Declan Breathnach, asked members to endorse the CEO's proposals, saying: "I would be seriously concerned that if there is no resolution we might be in danger of getting less than what he has offered."
Mr Breathnach told the meeting: "The board is not in a position to make clinical decisions," and afterwards said statutory agencies, "which in the main have Dáil approval in their powers and remit have, whether we like it or not, set standards of care for which the board has collective responsibility and an obligation to listen to and act upon."