Concern has been expressed that regular meetings were not taking place in recent months at Cavan General Hospital to review all surgical procedures on an ongoing basis.
The practice of having such weekly or monthly clinical audit meetings is now considered standard practice in hospitals so that patient care can be reviewed, complications if any can be discussed and lessons, if need be, learned.
One doctor in the north-east, who did not wish to be named, told The Irish Times yesterday that the lack of these audit meetings was "a huge concern".
The Irish Patients' Association said the fact that reviews had not been taking place was a matter of grave concern. "I'm surprised that regardless of what difficulties are in the hospital these matters of good governance are not in place, and it should be rectified immediately," the association's chairman, Mr Stephen McMahon, said.
The director of surgical affairs at the Royal College of Surgeons in Ireland, Prof Arthur Tanner, is to visit the hospital today. He will advise on how a peer review system can be reinstated in the surgical department.
He will also be interviewing candidates for long-term locum consultant surgeon posts. Locums have been coming and going from the hospital since two of its surgeons were suspended last August over interpersonal difficulties.
Dr William Joyce and Dr Pawan Rajpal, the doctors suspended, have in recent days taken High Court proceedings over their suspensions.
The North Eastern Health Board asked the Minister for Health, Mr Martin, last August to set up an inquiry into the suspensions, which is the procedure which must then take place under the 1970 Health Act. However, it has still not met. The delay has now resulted in blame passing between the Department of Health and the Irish Hospital Consultants' Association (IHCA) over who is responsible.
Yesterday the Department released a statement saying the IHCA had been unwilling to submit the names of people who would sit on the inquiry team because of concerns about how much they would be paid, among other things.
Mr Martin said later he was "extremely annoyed and frustrated" at the difficulties encountered setting up the inquiry.
Speaking before the launch of a new national system for the reporting of adverse incidents by hospitals, he said he had set up an inquiry in September which had had to be disbanded due to the withdrawal of both the appointed chairman and one of the consultant representatives.
A second committee was appointed in October. This had to be disbanded in December 2003 due to a perceived conflict of interest of one of the consultant representatives "and the subsequent refusal of the second IHCA member to continue due to, amongst other things, non-payment of fees for committee work".
Mr Martin said the manner in which such inquiries would be convened in future would be reviewed in the context of the new Health Act.
However, a new third inquiry team has now been appointed, he said. It will be chaired by Mr Andrew Bradley SC.
The IHCA denied it was responsible for the delays. Its secretary general, Mr Finbarr Fitzpatrick, claimed the whole affair had been handled in "a ham-fisted manner" by the Department of Health.