Consultants at Kerry General Hospital appeared yesterday before a special meeting of Kerry County Council to "appeal" to politicians to lobby for resources for the 274-bed acute hospital, the second-largest in the southern health region.
Consultant surgeon Tom McCormack said he and his colleagues had repeatedly highlighted the deficiencies to the HSE "to no avail", and there were fears now that Kerry General Hospital - ahead of its time when built 30 years ago - "was going to slip".
"It's been impossible to achieve progress through normal channels," Mr McCormack said.
In a stinging attack on the HSE, he said there was "no clear response to anything", adding "everything is long-fingered".
The HSE was more concerned with paperwork and was "bloated with managers and administrators but deficient in doctors and nurses".
For a post to be sanctioned "a rigmarole" of officialdom had to be gone through, he said.
The meeting also heard there were "chronic shortages" of staff in most departments in Kerry General with a catchment population of 140,000.
Dr Eamonn Bannan, radiologist, told how in 1997 his department had carried out 45,000 examinations with 14 staff. Last year it had performed 73,500 examinations but staff numbers didn't change.
Hospitals of a similar size had 20 radiographic staff, he noted. Moreover, similar size hospitals had five to seven radiologists while Kerry General had three.
"This is a totally unacceptable situation. We are in crisis," Dr Bannan said.
The HSE turned a deaf ear to pleas for more consultants and more radiographers, and the situation in his department was "a microcosm" of what was happening throughout the hospital.
Some 600 people were waiting for endoscopy examination, and the average wait for this telescopic examination of the bowel and other organs to detect cancers and ulcers was five months. Often the total wait from the time a patient saw their doctor was a year.
The meeting heard that surgery was often cancelled because the "very busy intensive care unit" was working to capacity. Moreover, a high-dependency unit, built four years ago out of voluntary contributions, lay idle. "Our requests for nursing staff [ for the unit] have been refused," Mr McCormack said.
Despite the fact that peninsulas tended to have higher than normal rates of coronary disease, Kerry General only had a part-time consultant cardiologist, consultant Richard Liston said.
Orthopaedics was also "struggling", John Rice said.
Obstetrician Mary McCaffrey told how there had been 1,850 deliveries in the hospital last year, an increase of 70 per cent on seven years ago but the promised dedicated maternity unit had not transpired. There were fewer beds now for maternity patients.
She said the hard work of the staff had won the support of Kerry people - in 1998 a third of women were going to Cork or Limerick to have their babies - but midwives confined to work in a unit designed for the needs of the 1970s were now under enormous pressure.
The meeting heard how the absence of a dedicated palliative hospice unit in the county had led to one patient being moved to a utility room to die in privacy.
Councillors described it as one of the most important meetings ever in the council chamber.
Ted Fitzgerald (FF) said the facts were now on the table and mayor of Kerry Michael Healy Rae said, "It has come to a stage when playing politics with the health service is no longer acceptable".
Most councillors said getting rid of the old council health committees and the health boards had led to a lack of real representation for the Kerry health services.
HSE representatives were invited but did not attend the council-organised meeting.