A group opposing the Hanly report on hospital reform has said it is clear from remarks made by the Tanaiste at the weekend that the Government is committed to downgrading local hospitals.
The Health Services Action Group (HSAG), an alliance of local hospital groups formed in response to the Hanly report on medical staffing, said Ms Harney's remarks at the PDs' annual conference were a "defence of the 'bigger is better' argument".
Ms Harney said that if the State wanted a world class health service, it could only be organised on a regional basis and that 24-hour consultant services could not be provided in every town, or even in every county, in Ireland.
The Tanaiste said this was "not just a question of money". "It is a question of population. You won't get a world-class team of doctors unless you have a critical mass in terms of population."
The HSAG said the remarks were "a defence of the central argument in Hanly that regional centres are necessary to deliver better outcomes for patients compared to smaller general hospitals".
Senator Kathleen O'Meara of the HSAG's interim steering committee said the evidence the group has put forward "shows beyond any doubt that bigger hospitals do not produce better outcomes for patients except for a very small number of very complex specialities".
"The analysis done for the HSAG by health economist Catherine McNamara shows that not only is there no evidence to support the central premise of Hanly - that bigger is better when it comes to hospital care. Despite this, the Government persists with it."
"In fact there no necessity to centralise hospital care as is proposed in the Hanly report, except in a desperate effort to solve the working hours of junior hospital doctors. But centralisation is also considerably more expensive for the taxpayer and would result in a much worse health service right across the country."
The HSAG said it is clear from the Tanaiste's speech in Killarney that the Government is committed to fully implementing the Hanly Report and downgrading local hospitals.
"This undoubtedly means that the Government plans to go ahead with the downgrading of 26 General Hospitals around the country, despite huge opposition to the plan and despite growing evidence that it is unnecessary and unworkable," she said.