The leaders of a campaign to develop services at Monaghan General Hospital said they had an "optimistic" meeting with officials of the Department of Health and Children yesterday.
But they still had to persuade the North Eastern Health Board to develop the hospital. Earlier, up to 3,000 supporters of the hospital marched through Dublin city centre to hold a meeting outside the Department's headquarters.
Speakers and marchers complained about what they saw as the downgrading of services at the hospital, which some saw as a downgrading of the Monaghan area in general.
The hospital was closed to emergency and elective surgery last month due to a lack of anaesthetists. The recruitment of a temporary anaesthetist provided a short-term solution to the problem. A longer-term solution, currently the subject of discussions between the NEHB, the College of Anaesthetists and local consultants,
would see a resumption of anaesthetic services in what the health board calls "a different but sustainable configuration".
However, the Hospital Community Alliance Group, which organised yesterday's demonstration, sees this as a proposal to curtail services through the provision of a 9 a.m. to 5 p.m. surgical clinic five days a week. Other than that, says the alliance chairman Mr Peadar McMahon, the hospital would simply provide geriatric and convalescent services.
The NEHB insists, however, it is committed to "the continuation and development of Monaghan Hospital as an integral part of the Cavan Monaghan Hospital Group". This, it says, would include services such as general surgery, general medicine, gynaecology, obstetrics and paediatric out-patient services.
However, the alliance wants services such as gynaecology provided as full-time services rather than on an out-patient basis. The development of services at the hospital would enable it to treat a sufficient volume of patients to satisfy the requirements of the professional bodies which lay down standards for medical treatment. These standards usually require a hospital to handle a certain volume of patients to enable specialists to maintain and enhance their skills.
According to the NEHB, the recent difficulties arose because the conditions set down by the College of Anaesthetists were not being met and the college could not approve training posts for junior hospital doctors.
"The colleges must be satisfied that the junior doctors will receive a broad range of experience and that they will get sufficient further training from consultants at the hospital."
The alliance argues that the best way to meet the requirements of the colleges which regulate hospital training is to put resources into the hospital and to build up its services.
By contrast, the solution currently under discussion would see Cavan General Hospital taking the lead role in relation to surgery.
Marchers said they were not happy at the prospect of losing emergency and other services at Monaghan and having to take a 50-minute trip to Cavan along bumpy roads. Mr McMahon said he was pleased with the meeting which he and other representative had with two senior officials yesterday. Their attitude was "very positive" and they "agreed with a lot of things we said".
The Department said later its officials had met the delegation from the group, had accepted a submission from it, had listened to the group's concerns and had undertaken to clarify a number of points with the health board during the coming days. These matters will then be further discussed with the alliance.
At yesterday's demonstration speakers said there was more than enough work for all hospitals in the North Eastern Health Board area.
"All the hospitals are overcrowded and overworked and in a crisis," said Mr Gerard Sherlock of the alliance.