The Government's proposed abolition of the health boards and the removal of local representatives from the hospital system have been condemned by an Independent TD.
Mr Paudge Connolly, who won a Dáil seat after he campaigned on a "Save Monaghan Hospital" ticket, said: "People will see this as the death of local democracy.
"I think people have over-estimated the level of policy input that councillors had. They acted as a local voice for local people," the Cavan/Monaghan TD said.
The consultants will resist change, he believed. "They will not be faced down easily. They have been trained by the public purse. They should give some time to public patients."
Dublin North Central Independent TD, Mr Finian McGrath, warned that the Government had to spend more money on the system along with demanding reforms.
All TDs should read the reports "very carefully" over the next week. "People can just react emotionally, but I don't think that that serves the health service well. In principle, we have to rationalise. We have to have efficiency. That is the name of the game," Mr McGrath said.
He believed hospital workers would give it a fair hearing. "They have to give the reports serious respect. I think trades unionists will deal with the reality of efforts in the interests of patients and taxpayers."
Independent Wexford TD, Dr Liam Twomey, said he believed that it was "a good idea" to get rid of health boards. "They really did not serve much of a function nowadays. Why do we need 25 or 30 people, be they politicians, consultants or whatever, and pay them expenses and buy them lap-tops? All that does is give the image of local democracy.
"The majority of the boards' budget was already pre-determined by the Department of Health and Children, which told them where they could spend their money," the Wexford TD said.
The creation of a clear line of authority from the Health Services Executive to the Minister for Health, continuing on to the Oireachtas would "get rid of the parish pump" from the health service.
He said he did not favour the survival of just five hospitals in Dublin and "five or six hospitals in the rest of the country". "We all want to defend local hospitals," he said.
However, he said, the Royal College of Surgeons, Comhairle na hOispideal and other such bodies have far more influence over the survival of local hospitals than politicians.
He welcomed the Minister's proposals to bring Comhairle Na hOispideal into the Health Services Executive, particularly if it loosened the grip held by consultants over new appointments.
His local hospital in Wexford was recently threatened with the loss of its A&E unit because consultants favoured the appointment of an A&E consultant to Waterford.
"Micheál Martin said he would approve the appointment of a consultant for Wexford over a year ago, but nothing has happened because Comhairle has held things up," he said.
