Senior doctors at Cavan General Hospital have recommended that patients be sent to Northern Ireland for surgery until difficulties at Cavan's surgery unit are resolved.
The recommendation has angered doctors in Monaghan who say Monaghan General Hospital should have been suggested instead of sending patients across the Border.
Dr Illona Duffy, a GP in Monaghan, said Monaghan Hospital had even been doing routine operations such as hernias for the Northern Ireland health service, and there was no reason for it to be "bypassed" by a hospital up the road.
She added that doctors in Monaghan were also concerned that the recommendations were put forward without consultation with Monaghan Hospital's medical board.
"Yet it's meant to be the Cavan-Monaghan hospital group," she said.
GPs from Cavan and Monaghan were called to a meeting in Cavan General Hospital last night to discuss the problems at Cavan hospital's surgical unit.
There have been concerns about continuity of care at the unit since the suspension last August of two of its consultant surgeons over interpersonal difficulties.
A letter which notified GPs of last night's meeting, and which has been seen by The Irish Times, set out what occurred when the medical board of Cavan Hospital met North Eastern Health Board chief executive Mr Paul Robinson last week.
It said the medical board chairman, Dr Paul Smith, "delineated the history of the current problem, which included high turnover of locum consultant surgical staff, loss of sub-speciality skills, reduction of Monaghan General Hospital services, continuing suspension of elective procedures, chronic blocking of surgical beds by medical admissions, the absence of any communication procedures between hospital management and general practitioners, and loss of public confidence in the hospital institutions".
Among the measures proposed by the medical board were:
An appropriate number of surgical beds should be reserved for the exclusive use of surgical patients.
The day ward should no longer be used as an overflow facility for acute medical admissions.
A rapid increase in the number of acute medical beds. At least 20 are needed.
The number of consultant surgeons in Cavan should be increased to four.
The possibility of buying in surgical services from Northern Ireland should be explored.
Daycare surgery in Monaghan hospital should be increased.
There should be extended hours for the endoscopy service in Cavan and Monaghan.
Formal communication with GPs regarding surgical services should be provided regularly.
The medical board requested a rapid response from Mr Robinson. The parties met last Thursday, and to date no decisions have been taken.
A health board spokeswoman said discussions were ongoing. She also said two long-term locum consultant surgeons were appointed last week.
Meanwhile, consultant staff at Monaghan Hospital and Monaghan GPs have written to the health board requesting it to put the hospital back on call.
They say this would relieve pressure on Cavan Hospital, which all this week has had to cancel elective surgery due to pressures on its accident and emergency unit.