The Department of Health and the HSE wanted to see key services at the troubled Midland Regional Hospital in Portlaoise closed down in June 2014, but the measures were never implemented.
Highly placed sources suggest there was a lack of political support for the proposed cuts, which would have included ending emergency and critical care services.
However, last night the department said practical implementation of the plan for Portlaoise hospital was an operational matter for the HSE, including the timelines for implementation.
The department said it “took the HSE longer to implement these actions than anticipated. However, all the issues which required immediate action have been addressed”.
A highly confidential action plan set out a number of immediate actions that should be taken to stabilise arrangements, including clinical decision-making then in place at the hospital.
The action plan also envisaged in the short- to medium- term the end of full-scale emergency unit and critical care services at the hospital.
There would also be cessation of in-patient surgical services and the reconfiguration of medical services to the level of those in a smaller “level 2” hospital, which dealt with less complex cases.
Action in 3-6 months
The plan, drawn up by the HSE and backed by the department at senior official level, called for changes to governance arrangements to be put in place within a fortnight and agreement to be reached on the service closures in 3-6 months.
The department said issues relating to service configuration were to be addressed after the top requirements were dealt with.
It said that these were “now being addressed as part of the strategic plan for the Dublin Midlands Hospital Group”.
The HSE confirmed on Thursday that senior health management met with representatives of the Taoiseach in early June 2014.
It said this meeting was called to provide a background briefing and an update on potential courses of action to improve services in Portlaoise.
The HSE said there was also one meeting with the Minister for Foreign Affairs Charlie Flanagan, who is a TD for Laois, about the hospital.
Politically acceptable
Asked whether it had been advised that that the plan was not acceptable politically, the HSE said: “As the national director for acute hospitals who was dealing with the action plan at that time is no longer in the HSE, it is impossible to determine this”.
The HSE said on Thursday that it was never anticipating that the actions envisaged under its plan would be implemented immediately but rather over time.
However, the plan itself sets out timelines for proposals, such as closure of services, would be agreed within three to six months.
On June 18th last year, several months after RTÉ revealed details of the death of a number of infants at the hospital, the HSE plan was presented to the then minister for health, Dr James Reilly, in a joint memo drawn up by the Department of Health's chief medical officer and another senior official.
“The necessary service reconfiguration requirements,” the memo stated, “will ultimately result in cessation of emergency department and critical care services, cessation of inpatient surgical services, reconfiguration of medical services in line with model 2 provisions including development of day surgery, medical assessment unit and ambulatory care.”
The memo said the department was “fully in agreement” with the HSE proposals.
