A US offer to equip one of the west's leading hospitals with a neurosurgical unit is in jeopardy, following a decision by the Department of Health and Children to commission a review of such services - which the west lacks.
The Department agreed to initiate the review at a meeting held in Dublin just over a week ago.
However, it would not rise to the offer of a gift of US $4 million in vital equipment in exchange for a commitment to include a neurosurgical unit in phase two of the University College Hospital Galway's (UCHG) current building plan.
This could have provided the west with its first neurosurgical treatment centre for emergency cases involving brain and other serious injury, which currently have to be referred to Beaumont Hospital in Dublin, or Cork.
The Western Neurosurgery Campaign (WNC) says it makes a mockery of the Government's Equality and Fairness health strategy, and shows once again that the west is being treated as a "poor relation of the east" in relation to medical services, including cancer treatment.
A neurosurgical unit in UCHG would not only make a major difference to chances of recovery in a serious accident, but would also be cost effective, the campaign says.
Nor would a unit in the west need to exclude expansion at Beamont in Dublin, it says.
The campaign comprises representatives of the medical and nursing professions and members of the general public.
Its patron is Prof Patrick Kelly, Chairman of the Department of Neurosurgery at New York Medical Centre in Manhattan, who spoke in NUI, Galway last September.
Its chair is Ms Pam Fleming, whose son, Sammy (25), was seriously injured in a road accident on the night that Princess Diana died, in 1997.
In an e-mail from Mr Paul Barron, assistant secretary of the Department, to Ms Fleming, chairwoman of the WNC, he says the Department acknowledged the need to expand neurosurgical capacity.
One of the key questions is whether further development should occur at Beaumont or at some other centre.
It is now over 10 years since Comhairle na nOspidéal last undertook a review of neurosurgical services, he says.
"Given the passage of time since then and in the light of the announcement in the Health Strategy Quality and Fairness of the Government's intention to provide an additional 3,000 acute hospital beds by 2011, the Department considers that an up-to-date further review of neurosurgical services should be undertaken, focusing in particular on issues of capacity and geographic configuration," Mr Barron says.
"Comhairle na nOispidéal has been asked to give priority to the carrying out of such a review and to the preparation of a report for consideration by the Minister. I will keep you informed of developments."
Asked to comment, the Department of Health and Children said the review had been earmarked as a priority, but no decision on the US offer could be taken before then.
As Ms Fleming, chair of the WNC, points out, up to 80 per cent of neurosurgical admissions are classified as "emergencies".
"The critical thing about these emergencies is timely intervention to prevent irreversible brain damage."
Any delay could mean the difference between life or death, or the difference between a full recovery and a poor outcome (e.g. disability), she says.
At the meeting on February 12th in the Department of Health and Children, the WNC representatives stressed the economic sense and value-for-money that neurosurgery offers as agreed by health economists.
"This is an election year," Ms Fleming says. "We don't want this issue to be used as a political football or an opportunity to score political points. Rather, we would like an example of political decisiveness."