Analysis: Last June Prof Ciarán Bolger, a consultant neurosurgeon at Dublin's Beaumont Hospital, described Ireland's neurosurgery service as a "mess".
He claimed people were dying unnecessarily as a result.
There had been no increase in the number of neurosurgeons working in the Irish health service in 25 years, and fewer neurosurgery operating slots were now available than two decades ago, he said. The result was that even "urgent" cases had to go on a waiting list.
His comments are borne out by a review of neurosurgical services carried out for the HSE, details of which are published by The Irish Times today.
The review by Comhairle na nOspidéal began in 2002 and was signed off in December 2005.
Given that it highlights our neurosurgical services to be in such an appalling state, it is not surprising that it has taken the HSE nine months to decide on whether to release the review under the Freedom of Information Act.
The report recommends action be taken as soon as possible to increase the neurosurgery units' capacity at Beaumont Hospital and at Cork University Hospital. And the HSE has said it is committed to doing this. Welcome news indeed.
But those in the west, as the report acknowledges, will be disappointed. For many years the former Western Health Board, concerned citizens and politicians along the western seaboard have campaigned for a neurosurgery unit at University College Hospital, Galway.
In a submission to the review group, the Western Neurosurgery Campaign argued for a unit in Galway, saying people in the west could not access care in the existing units in Dublin and Cork in a timely fashion. They also felt the distances from the other two units for the people in the west, as well as the fact that the Galway unit would have a catchment population of up to 750,000, would make a unit in the west viable.
However, the report says consultant neurosurgeons stated their "unanimous opposition" to a third neurosurgical unit. The review group agreed with them.
The review group believed a Galway unit's catchment population would be insufficient to generate a workload sufficient to maintain the expertise of staff who would work there - even when population projections to 2021 were considered.
It also said establishing a Galway unit would negatively affect the Cork unit by reducing its catchment population.
Furthermore, it said: "The direction of resources towards the establishment of a new unit in Galway would impact negatively on the ability of the system to invest in much needed resources for the development of paediatric and other sub-specialty areas in the de facto national unit in Dublin."
While the delivery of health services close to home was highly desirable, the provision of safe, high quality care provided by appropriately trained staff was, on balance, more important, the report concluded.