New proposals aimed at restoring a "significant level of acute services" at Monaghan General Hospital will be drafted "in the coming days", according to the North Eastern Health Board.
Last month, the board rejected proposals put forward by the hospital's consultants through its association, the Irish Hospital Consultants' Association (IHCA), to provide an interim solution to the controversy over on-call services.
The hospital has been off-call for emergencies since July and surgery has been disrupted because the hospital does not meet the requirements for training anaesthetists. As a result, the hospital cannot recruit non-EU trainee anaesthetists.
The IHCA said it would welcome "sight of the proposals" but believed that its own plan was reasonable, and was operated by other acute hospitals, when the level of on-call demand was greater than capacity. "It is our view that the North Eastern Health Board has allowed the crisis to develop," said Mr Finbarr Fitzpatrick, its general secretary, who said the board's management "blamed everybody but themselves".
The board could have recruited fully registered non-consultant hospital doctors. They were difficult, "but not impossible to get" and Naas General hospital was able to re-introduce on-call cover this way.
A spokeswoman for the health board declined to specify what the proposals were, as they were being finalised in talks between the board and its medical adviser. However, in a statement the board said the proposals would be put to the consultants for their consideration.
The hospital consultants' proposals involved the appointment of a transport co-ordinator to organise an ambulance with anaesthetic cover for the immediate transfer of patients to another hospital, when demand for emergency services was greater than capacity at Monaghan General.
The health board said it sought independent external medical advice on the consultants' proposals. The "independent medical advice available to the board expressed grave concern about any system that requires immediate availability for so many personnel not already involved in that hospital". The time factor involved in organising this could be considerable and "inevitable delays could have serious consequences for patients".
Mr Paudge Connolly, the local Independent TD, elected as a Monaghan hospital campaigner, said the health board had failed to identify who was giving it "independent hospital advice". The "key thing is that the board is not listening to people on the ground".
As a result of the disruption in surgery at Monaghan General, waiting lists had increased to 18 months at Cavan General Hospital, "clogging" an already overstretched hospital, said Mr Connolly. "Other hospitals cannot cope" while Monaghan is off-call.
