The Minister for Health will today publish the consultants' report on Tallaght Hospital against a background of bitter recrimination between himself and his department and the hospital management.
Confirming that he would lay the controversial 211-page Deloitte and Touche report before the Oireachtas today, Mr Cowen last night utterly rejected "the unworthy and unjustified assertion" in a hospital board statement that he misled the Dail.
The Minister also denied accusations by the board of management that he or his department had selectively leaked the report.
The conflict deepened yesterday when the treasurer of the board, Prof David McConnell, implied that the matter should be taken out of the Minister's hands, and proposed that it be handled henceforth at the "highest level of Government".
Mr Cowen responded sharply that he was the Minister and, with his department, would deal with the matter.
These exchanges followed an assertion by the board's chairwoman, Ms Rosemary French, that she felt "totally betrayed by the outrageous statements" made by the department last week on the hospital.
The Deloitte and Touche report found a total overrun of £13.3 million and a potential overrun of £4.3 million in capital expenditure at the hospital. A dispute erupted after Mr Cowen delivered the report to management and subsequently issued a brief statement confirming the deficit.
He said it indicated "serious governance and general management problems at the hospital".
Stung by the Minister's remarks, and amid Opposition claims that the report was also critical of the department, senior representatives of the hospital board took issue with the Minister publicly.
Prof McConnell said that trust had broken down. Ms French accused the department of a "breach of trust", claiming that it had undertaken not to comment in public on the report until the board had an opportunity to consider its contents.
Strongly rejecting this claim, Mr Cowen insisted last night that it was incumbent on him, in response to numerous media queries, to state publicly that the report had been given to the hospital board and to "make some limited references to its findings".
He had used the actual deficit figures referred to in the report because two national newspapers had, that morning, speculated on amounts "far larger" than the reality.
Indicating no softening in his attitude to delivering an extra financial allocation, he also reaffirmed that "hospitals have to operate within the budgets they are given". However, he said he and his department wished to establish Tallaght Hospital on a sound footing.
Putting the hospital on "a sound footing" involved a recognition that it must deal with the financial problem and "it must agree with me a modus operandi for effecting change".
"The sooner this is done, the sooner the real issues can be addressed," the Minister added.
Meanwhile the chief executive officer of the hospital, Dr David McCutcheon, told Medicine Weekly he has no intention of stepping down.
Fine Gael's health spokesman, Mr Alan Shatter, said the Minister must bear "total responsibility".
"By not publishing the report last week, he allowed the problem to fester and committed an extraordinary and unprecedented breach of faith with the hospital board. It is unfortunate that, instead of him voluntarily publishing the report, he has been forced to reluctantly publish."
Democratic Left's spokeswoman on health, Ms Liz McManus, criticised the Minister's handling of the report. Either the Minister or his department, she said, had been involved in selective leaking of extracts critical of hospital management.
However, sections which she said reflected poorly on Mr Cowen and his department had been "suppressed".