Professor Matthew Sadlier:

We do have a view, which is that there should be safe emergency care for the people of the country and the people of the mid-west. We do not have a view on which hospital should be used and how it should be configured. That is a question for the HSE. Since I graduated 25 years ago, medicine has become much more complicated but the survival rates and the treatment of many conditions have improved greatly. I will take stroke care as a very simple example. When I graduated in 1999, if somebody had a stroke, there was largely no intervention to preserve brain tissue. Now, we try to use anticoagulant therapy and clot-melting therapy - that is probably not the best term but it is the only one that comes to my brain - to reverse clots and save brain tissue so that people can have much better functional recoveries. However, that requires intensive medical input. You need an emergency department that is able to provide such care. You also need an emergency department that is able to provide somebody who has had a cardiovascular event with an angiogram or angioplasty within a certain timeframe. The sooner that is done, the more of the person's heart function will be saved and the more likely it is that the person's life will be saved. Opening emergency departments that do not have the necessary facilities, something that is basically just a barn with the word "hospital" over it and where doctors have minimal equipment, support staff and investigation capacity, is not going to help the health of the people of Ireland. It may help waiting times but it is a false economy. Where those departments should be is not our call but we need to be able to provide proper medical care to the citizens of Ireland and to be able to make sure that, when somebody arrives to hospital with a serious medical condition, it can be treated.