Fears are being expressed about the loss of further services at Monaghan General Hospital following the decision by the North Eastern Health Board to end the contracts of five junior doctors specialising in surgery there.
The contacts of the surgical senior house officers will not be renewed in January, they have been told.
Furthermore, two surgical registrars at the hospital whose contracts expire in six months time have been approached about moving to Cavan General Hospital.
The move has outraged the local hospital action group which says if surgery is removed from the hospital it will spell the "death knell" for the hospital.
Mr Peadar McMahon, of the Monaghan Community Hospital Alliance, said the move was unexpected and did not appear to be in line with a recently-published steering group report on the setting up of a joint surgery department between Cavan and Monaghan hospitals which recommended that "selective" elective surgery should be carried out at Monaghan.
Dr Illona Duffy, a GP in Monaghan, said the decision meant the health board was trying to close the hospital's surgical department without putting an alternative in place. She said Cavan hospital would not be able to cope.
"If we lose surgery now, we have basically lost the hospital," she said.
The hospital has already lost maternity and gynaecology services, and has been off-call to emergencies for over two years.
Monaghan hospital has up to now being carrying out minor and intermediate surgery. However it is understood the health board believes it should provide day surgery only. It has been advised by Mr Finbar Lennon, its medical adviser, to this effect.
A spokeswoman for the health board said its communication with junior doctors marked the beginning of its implementation of the steering group's report. "It does not mean the surgery unit will close," she said.
Meanwhile, in a separate development, the hospital is also losing its hospice room. The facility, opened in 1994, was built and equipped with funding from the National Lottery and a local contribution of over £25,000. Only a small number of patients have used it due to staffing and other problems, and now the local committee has been asked to remove whatever equipment it supplied as the building is to be redesignated as a day-centre.