Professor Colette Cowan:

It is a difficult question because model 3 hospitals require specific resourcing. They need high-dependency care and specialist teams. There are several model 3 hospitals around the country that one could examine in terms of staffing. It can be quite difficult, which can lead to adverse events. One has to balance according to the potential impact in the region. Our view is that the elective hospital would assist the model 4 hospitals, but reopening emergency departments at other sites would require significant investment, and there would be safety issues concerning care. For example, if as a member of the public I went to Nenagh hospital clasping my chest with a heart attack, I would like to know I was going to a cardiologist who stents every day of the week. That would not be the case in Nenagh hospital. We have to regionalise some very specialist disciplines, such as cardiology, in UHL.