One of the State's leading transplant surgeons has called for Beaumont Hospital in north Dublin to be scrapped and a new hospital built on the site.
Dr David Hickey, the director of the kidney and pancreas transplant unit at Beaumont, which is the biggest unit of its kind in Britain and Ireland, claims the north Dublin facility is no longer suitable for use as a hospital.
He said the roof and windows were leaking, the air-conditioning was either non-existent or did not work properly, and the hospital was so chronically short of beds that vital cancer operations were cancelled regularly.
The intensive care unit was inadequate, parts of the hospital were temporary buildings and facilities for live-in junior doctors were sub-standard, he said.
"It is freezing in winter and roasting in the summer. You can't breathe in the place," he said. For 40 live-in junior doctors there was only one working shower for male doctors.
"In the last five years 17 junior doctors have left Beaumont. Twenty years ago if one left it would have been a case study."
Dr Hickey believes there is sufficient space within the hospital campus to build a new facility from scratch.
The UK Transplant Service, which includes Ireland, issued a report in 1997 stipulating that there should be six transplant beds per million of population, one-third of which should be single beds, he said.
"That would mean 24 beds for us, but we have six beds for transplant patients. It's a disaster."
The shortage means transplant patients are catered for in the hospital's urology department. That department treats cancer of the prostate, the most common form in men after lung cancer.
"We are cancelling cancer operations. I am amazed the patient takes it, I'd go absolutely ballistic if it happened to me," Dr Hickey said. In Beaumont there was just one diabetologist despite the fact that around 6,000 diabetics attended the hospital, he said.
"These are not easy patients. They have blood sugar problems, eye problems, high stroke rates, higher heart-attack rates, amputation rates and huge social problems," Dr Hickey said.
In many cases the emphasis in spending on health lay with investing in "palatial" headquarters for the "blazer brigade" rather than on facilities for patients.
He said politics needed to be taken out of the health service and that the decisions on where to invest in new facilities in recent years depended on the constituency of the ministers in office at the time.
"It's local votes all the time. If Healy Rae gets to be minister for health, and why not, you'd probably find something on Inishvickillane".
In an interview with The Irish Times he also warned that the health system was so underresourced and neglected that with the growth of private health facilities in coming years there would be an exodus of doctors and nurses from the public health system.
Dr Hickey was also critical of the current nursing degree, claiming it put too much emphasis on academic achievement and was flooding the healthcare system with nurses who were unsuitable.
Many new nurses had no long-term interest in the job and only pursued it as a means to a career in other areas of healthcare such as pharmacy, he said.
Dr Hickey also criticised the recruitment into the Irish health system of non-national doctors, saying bringing them from their own countries was a "patch-up measure" and was costing lives in those doctors' homelands.
"We are going to areas in the Third World where they have even fewer doctors than we have ourselves, places like India, Pakistan and Bangladesh, and recruiting. It's a neo-colonial attitude that we have adopted since we became the Celtic Tiger.
"The Third World every year donates around $1 billion worth of free medical education to scavengers like ourselves. People are dying because of that," Dr Hickey said.
