A proposal to relocate single-speciality hospitals, such as the State's main maternity hospitals, to the same site as acute general hospitals, has been described as "disturbing" by Labour's health spokeswoman, Ms Liz McManus.
The proposal has been outlined in a draft report from the Government-appointed task force on medical staffing.
Ms McManus said that before any decisions were made on foot of the report there would have to be full discussion of its recommendations. "I will certainly be insisting that the authors of this report appear before the Oireachtas committee on health to justify their proposals," she said.
However, Prof Walter Prendiville, a consultant obstetrician and gynaecologist at the Coombe Women's Hospital, believes there is "some merit" in the idea. But he said the plan was also "fraught with risk" as there were not enough beds in the major hospitals. "If you moved the Coombe to Tallaght, for example, elective gynaecology would end overnight unless there was some protection of beds," he said.
The report takes this point on board. It says: "It would be important not to lose the significant advantage currently offered by single-speciality hospitals - that of protecting elective activity from emergency work" after transfer to a regional centre.
The report suggests regional centres should deliver acute hospital care to populations of between 350,000 and 500,000 people. It also proposes the appointment of over 1,000 extra hospital consultants to provide a consultant-provided, rather than consultant-led, service. Longer working hours would become the norm, with the report pointing out that "the concept of a core working day is simply not appropriate to a 24-hour, 7-day service such as healthcare".
Setting out its thinking for single-speciality hospitals, the taskforce says: "At present, some regions throughout the country have single-speciality hospitals in such areas as orthopaedics, obstetrics and gynaecology, paediatrics, cancer and dermatology. The taskforce believes that, ultimately, all such single-speciality hospitals are best based on the same site as the regional centre. It would enable much more speedy access to on-site support services and greatly reduce the need for consultants and other staff to spend time travelling between sites".
It adds: "The taskforce is conscious of the logistical and financial implications of this policy and recognises that it would take some years to achieve".
No hospitals are mentioned; however, the large maternity hospitals in Dublin, such as the Rotunda, Holles Street and the Coombe, as well as St Luke's Hospital in Rathgar, the State's only dedicated cancer hospital, would presumably be affected.
Fine Gael's health spokeswoman, Ms Olivia Mitchell, said that in the long term, it might make sense to have all specialities on one site.
However, she stressed it was important that alternatives be put in place before any service was removed.