Recruiting additional staff and securing improved facilities are the two major challenges facing the Midland Health Board, its chief executive officer has said.
Mr Denis Doherty said there were "relatively long" waiting lists for a number of specialities including orthopaedics in the region but they would not be reduced to "generally tolerable levels" until a new hospital was built in Tullamore.
Planning permission was granted earlier this year by Offaly County Council for a £100 million hospital in Tullamore. It is hoped building work will begin later this year.
Mr O'Doherty's comments were in the board's report for 2000, which records activity levels in the board's hospitals over the past year.
He said their budget had grown by 115 per cent over the past five years and reflected the expansion in the need for services.
"However, further time is required to develop the service delivery capacity of the board. Additional staff and improved facilities are the two main considerations.
"At present, healthcare staff are in short supply. This situation is unlikely to improve until the capacity of the training institutions is expanded and begins to produce a higher number of graduates who will be attracted to the Irish health services.
"This is likely to take three or four years. In the meantime the health board will continue to seek to attract Irish health professionals working abroad and to provide opportunities for health professionals from other countries," he added.
Mr Doherty said the type of facilities a health board had could dictate the staff it attracted.
"High-quality facilities contribute towards attracting and retaining high-calibre staff and help to improve both service quality and productivity."
He blamed inadequate facilities on the fact that the Midland Health Board (MHB) had not met targets to reduce waiting lists last year.
However, staff was still making progress and had reduced the numbers waiting for orthopaedics from 612 in 1999 to 469 at the end of last year, and in ENT (ear, nose and throat) from 1,116 at the end of 1999 to 1,025 at the end of 2000.
On the other hand, waiting lists for gynaecology in both the Longford/Westmeath and Portlaoise General Hospitals were eliminated in 2000, he said.
Mr Doherty said investment in health and social services in the midlands was of great importance "in that the region is still striving to match the levels of economic growth achieved in other regions of the State".
He pointed out that a growth of spending on health services not only benefited patients, but also the local economy.
The MHB employs 4,200 staff who, together with temporary staff and pensioners, were paid £124 million last year.
Meanwhile, figures in the annual report show there were over 3,000 births to MHB residents last year, but approximately one-third of women chose to have their babies in hospitals outside the health board area. The birth rate has remained relatively stable since 1990.
It also showed there had been more than a fivefold increase to 46 in the number of cases of measles in the region last year, a trend mirrored elsewhere in the State.
However, measures were implemented to increase the uptake of the MMR (measles, mumps and rubella) vaccine, and by the end of 2000 the uptake had increased from 70 to 80 per cent.
There were 33 cases of meningococcal disease (septicaemia and meningitis), two of which proved fatal. There were also seven cases of E.coli 0157, a severe and dangerous form of food poisoning.