The Minister for Health has asked the groups implementing the Hanly report recommendations in the mid-west and east coast regions to ensure medical cover will continued to be provided overnight in each acute hospital.

"The issue will also form a part of the work of the acute hospitals review group which is to develop a national hospitals' plan in line with the principles of the report," said Mr Martin.

The Minister was responding to the Labour spokeswoman on health, Ms Liz McManus, who asked him the meaning of the promise that 24-hour medical cover would be retained by local hospitals in line with the commitment given by the Taoiseach, Mr Ahern, in March.

Mr Martin said medical cover meant that a doctor was available to provide a medical assessment or treatment overnight.

"The grade of doctor called on to provide medical cover will be in line with anticipated patient need," he said.

Ms McManus said there was deep confusion about the Hanly report recommendations. "The decision and recommendation in Hanly is to downgrade accident and emergency to the point where it is meaningless in the sense that it is specifically described in the report as a minor injuries unit which is nurse-led, open during the day, not open at night and all medical emergency care is directed to a major hospital."

Mr Martin said it was not as if every line of the report was set in stone and that was his policy in terms of the issue. "The Hanly report makes it very clear that 70 per cent of what is currently going through accident and emergency services will continue to be dealt with by smaller hospitals," he said.