The outcome for many election hopefuls will depend on the extent to which people fear for their local health services, writes Theresa Judge
Fears over the downgrading of local hospitals is a key issue in at least six constituencies and the performance of Government candidates in these areas will have an important impact on the outcome of the general election.
Given that health is widely regarded as the main issue in this election, there are a large number of candidates, both Independents and members of Opposition parties, campaigning primarily on health issues in addition to those who have been involved in campaigns to retain services in smaller rural hospitals.
Fine Gael and Labour are hoping that concerns over the health services will translate into more seats for them on this occasion rather than for Independents, as occurred in 2002.
Then at least five Independent TDs, for whom health was clearly their top issue, were elected.
A number of other left-leaning Independents cited health services among their top three or four issues.
Among them was Wexford TD Dr Liam Twomey, Fine Gael's health spokesman.
It has clearly been a strategy of Fine Gael to field candidates associated with health - the party is running five doctors, among them Dr John Barton in Galway East, a consultant in Portiuncula hospital in Ballinasloe who was chairman of an umbrella committee of local action groups opposed to the downgrading of smaller hospitals.
Alongside Barton on the action group is Senator Kathleen O'Meara of the Labour Party in Tipperary North, who has been very prominent in the campaign for Nenagh hospital, and Brian Meaney of the Green Party who has campaigned to retain services at Ennis hospital.
In most constituencies where "health Independents" were elected in 2002, concerns over local hospitals remain or have even magnified.
This is particularly the case in Cavan/Monaghan where Independent Paudge Connolly is trying to retain his seat.
The release by Sinn Féin last week of a draft HSE report into planned reconfiguration of hospital services in the northeast will have helped push the issue further up the agenda, as it proposes just one acute hospital in the region.
Paudge Connolly, who campaigned mainly in 2002 on the retention of services at Monaghan General Hospital and who received nearly 8,000 first-preference votes, says it is an issue now not just in Monaghan but in Cavan as well.
"It is a huge issue on the doorsteps, many people are only realising now what they intend to do with the services and people are frightened," he says.
People fear the new regional hospital may be located south of Drogheda, he says.
Connolly's prospects of re-election are not straightforward, however, given that one of the five seats automatically goes to Dáil Ceann Comhairle Rory O'Hanlon.
Peadar McMahon of the Monaghan Hospital Action Group says his advice to voters is to vote for anybody except Government parties.
This is because all the main Opposition parties, Fine Gael, Labour, Sinn Féin and the Greens, have given commitments to meet the eight demands of the action group including the retention of existing services, the restoration of others and a full A&E department.
With just four seats available in Cavan/Monaghan, it will be more difficult for an Independent to get elected. Sinn Féin's Caoimhghín Ó Caoláin is expected to retain his seat.
The final outcome will depend on the strength of anger towards Fianna Fáil and whether people believe that an Independent or a Fine Gael candidate will be more effective in saving local services.
Other constituencies where local hospital campaigns will affect the outcome include Clare, Galway East, Tipperary North and Roscommon/south Leitrim.
In Clare, Independent TD James Breen, who campaigned in 2002 on the issue of Ennis General Hospital, is fighting to hold onto his seat.
Fine Gael should have a good chance of taking the second seat from him, particularly if there is a swing nationally towards the party, although the decision to run four candidates will not help.
However, Green candidate Brian Meaney has also been active in the hospital campaign and may also take votes from Breen.
Fianna Fáil, meanwhile, has been trying to reassure voters about Ennis hospital with adverts being placed in local papers about a long-awaited €40 million upgrade.
However, hospital campaigners are reminding voters that a HSE review of hospital services in the midwest is under way and that the A&E unit may close after the election.
In Tipperary North, Senator Kathleen O'Meara of Labour is challenging for a seat and her high-profile role in campaigning for Nenagh hospital will help her vote.
While Michael Lowry seems assured of getting elected here, Fianna Fáil is considered likely to lose one of its two seats and O'Meara believes she may be able to take it.
She is highly critical of Fianna Fáil candidates for saying the future of the hospital is assured.
"In 2002, in the absence of an alternative, a lot of voters drifted to Independents. But this election is much more focused and people want to vote for someone who could play a role in the next government," O'Meara says.
In Galway East where Dr John Barton is running for Fine Gael, there is already an Independent, Paddy McHugh, who campaigned primarily on a health issue - the reopening of Tuam hospital. McHugh, like James Breen, is a former member of Fianna Fáil.
On this occasion the re-opening of Tuam hospital may not be as big an issue as it was in 2002. And on this occasion voters who prioritise hospital services have a choice of two candidates - Barton and McHugh.
Barton is totally opposed to Government policy of downgrading smaller hospitals and argues that for "the vast bulk of conditions" and given the poor condition of rural roads, local hospitals provide the best services.
This is an argument repeated in neighbouring Roscommon/south Leitrim by Independent challenger John Kelly. The Roscommon Hospital Action Group is supporting Kelly, a community welfare officer who pulled off a surprise win in the last local elections. Last August the HSE unveiled a plan to move all inpatient surgery to Ballinasloe.
Other Independents with a strong health agenda include Jerry Cowley in Mayo and Finian McGrath in Dublin North Central.
O'Meara's prediction that there will be a shift from Independents may prove correct. Ultimately, the outcome in some key constituencies will depend on the extent to which people fear for local health services, whether Fianna Fáil assurances are believed, and whether voters believe Independents or Opposition party candidates can do more to deliver improved services.