The Health Service Executive moved yesterday to further centralise cancer services in the midwest.
It said it had decided to concentrate all mammography services for the region at a specialist breast unit in the Midwestern Regional Hospital in Limerick.
This means mammograms will no longer be performed at Ennis General Hospital.
A decision was taken some time ago to also stop doing mammograms at Nenagh General Hospital.
The news was described as worrying by the Fine Gael TD for Clare, Joe Carey. "Undoubtedly this is a further erosion of services in the county, and I fear it is the first one of the steps in an overall move to centralisation of services," he said.
But Prof Rajnish Gupta, director of cancer care services for the HSE in the midwest, said the move was in the best interests of patients.
"Quite simply, the time came to bite the bullet. Centres where less than 1,000 mammograms are being done in a year do not provide the volume of work necessary for the maintenance of the required level of professional skills," he said.
Ennis had been doing about 600 mammograms a year and Nenagh had been doing around 300.
The changes were announced at a press conference at which Prof Gupta revealed no additional staff have been appointed to work in the area of cancer care in the region in the past 2½ years, despite a 50 per cent increase in workload in that period.
He has still not received any response from the HSE to a request he made for additional staff in 2004, he said.
These include a breast surgeon, a part-time plastic surgeon, a radiologist with an interest in breast radiology, a radiographer, a breast care nurse, a cancer sister co-ordinator and advanced nurse practitioner in breast services.
An additional theatre, operating three days a week, and the appropriate staff to allow all breast surgery to take place, including reconstructive surgery, are also needed, according to the cancer care specialist.
The mammogram machine at Ennis Hospital had been out of commission since October last; since then a total of 402 patients from Clare have had mammograms carried out in Galway.
Clare patients requiring mammograms between now and September will continue to be referred to Galway, after which date they will be referred to Limerick, according to the HSE.
The specialist breast unit in Limerick is designed to cater for a population of 300,000 to 350,000, from which it is expected there will be, at a minimum, 100 new primary breast cancer cases a year.
"I have no concerns about developing things in a specialised unit. In terms of mammography, I have no difficulty in agreeing with the move - it has to be done. But in terms of advancing services and maintaining services, then we do need more resources," Prof Gupta said.
Meanwhile, John Hennessey, manager of the HSE acute hospital network in the midwest region, said a specialist breast unit can open in Limerick with existing staff and insisted the hospital will be delivering on extra resources in time.
A new €2.6 million specialist breast unit is being planned at the hospital. The project is expected to go to tender before the end of 2007 and to be fully commissioned in 2008.
Meanwhile, an expert group set up to inquire into a series of logjams in the A&E department at the Limerick hospital last January has called for better use to be made of non-acute beds.