The selection of a site for a new regional hospital in the northeast into which all emergency services in the region are due to be centralised has been delayed.
It has emerged that the decision on a site has been deferred to allow discussions to take place with health authorities north of the Border on whether it would be best to locate the hospital on a site that would suit patients North and South.
The decision to go ahead with a new hospital in the region, which already has five hospitals - Navan, Cavan, Monaghan, Dundalk and Drogheda - was made by the Health Service Executive in June 2006.
This followed the publication of an independent review of acute hospital services in the northeast which found that patients were being put at risk by the way services are organised.
A new hospital for the northeast was also recommended by the Lourdes hospital inquiry report when it was published in February 2006.
The HSE selected outside consultants earlier this year to recommend the best possible site options for the new hospital. A number of possible sites were identified; however, none has yet been chosen.
The discussions on a site that might facilitate patients from Northern Ireland are ongoing and Prof Brendan Drumm, chief executive of the HSE, said they were taking place "at a political level".
However, he said he understood those discussions were "now almost complete" and it should be possible soon "to actually determine, including or excluding the North, which potential sites could actually be picked for the provision of this service".
He told The Irish Times the site chosen "clearly would be different whether or not the Northern population was included".
He was hopeful, he said, that by February a decision could be made on the site for the new hospital. Asked when people could then expect the hospital to be built, he indicated that would depend on funding.
"I think there is a whole process then of actually entering into the whole identifying of capital to support such a programme . . . that will be very much a Government decision in terms of funding."
When the independent review of acute hospital services in the northeast was published by Teamwork in mid-2006, the HSE indicated then it hoped the new hospital would be built by 2015.
The Teamwork report envisaged that the hospital would provide A&E services for the entire northeast area as well as emergency surgery, paediatrics and possibly maternity services.