A plan by the Health Service Executive to curb the influx of patients from the regions to Dublin hospitals for treatment which they could access at home has been dismissed by the Irish Hospital Consultants Association as "an old plan in new clothes for the new year".
Finbarr Fitzpatrick, secretary general of the IHCA, yesterday said the plan being put forward as one of a number of initiatives to alleviate overcrowding in A&E units in Dublin in 2006 would be very difficult to implement.
He said specialist consultant- to-consultant referrals could not be interfered with and that there had to be recognition of a patient's entitlement to choose and their GP's entitlement to choose where they should be treated.
Mr Fitzpatrick also said if something went wrong when a patient was refused admission by a Dublin hospital, the hospital might have to accept the medico-legal consequences.
Under its plan the HSE says that in future the five main Dublin hospitals - the Mater, Beaumont, Tallaght, St Vincent's and St James's - should only accept patients from the regions if they are seeking services not available in their own areas or if they have been referred by a specialist.
A similar plan was envisaged by the former Eastern Regional Health Authority in 2003 but was never implemented.
Pat McLoughlin, deputy chief executive of the HSE, said: "There are many situations that we have looked at where patients are being referred without any good reason to Dublin hospitals when they could be treated in their own area."
They were being referred for orthopaedic and ophthalmic procedures for example, which they could avail of locally.
He believed this plan would succeed now where the ERHA had failed because as one statutory body, it was in "a much stronger position to develop national protocols" that hospitals would have to implement.
Discussions would take place with GPs this month on the new plan and Dublin hospitals would be discussing it with their consultant staff and would be monitoring its implementation, he said.
"We are talking about changing patterns of referrals that have been there for decades," Mr McLoughlin added. "It's going to take time."
The HSE says it also plans to get hospitals to spread elective surgery throughout the week to ease pressure on beds in the earlier part of the week and it will open three new A&E developments at Dublin hospitals shortly.
Its claim that there had been up to a 20 per cent drop in numbers on trolleys in A&E units was rejected by the Irish Nurses Organisation. It said the level of overcrowding, both in Dublin and certain hospitals around the country, was as severe as ever.
"A more accurate comparison, involving the first five working days of February and December, confirms that the daily level of overcrowding nationwide, went from 244 (February) to 303 (December)," its general secretary Liam Doran said.
The key to solving A&E overcrowding, he added, was more acute hospital beds. The IHCA and Irish Medical Organisation agreed.
IMO president Dr Asam Ishtiaq also said it would take years for the HSE to solve the A&E crisis given its current rate of progress.
Labour's health spokeswoman Liz McManus said the new HSE proposals represented an implicit admission that the 10-point plan by the Minister, Mary Harney, to tackle the A&E crisis 15 months ago, had failed.
"Any plan that fails to recognise the urgent need for additional bed capacity is unlikely to have any significant impact on the problem," Ms McManus added.