A report by the Institute of Obstetricians and Gynaecologists in 2000 advised all health boards in regard to the level of consultant staffing requirements to provide an appropriate level of consultant care in the maternity and gynaecological services. The institute considered that a viable unit requires in the region of 1,000 births per year to enable consultants to maintain their expertise. The report, having examined the level of obstetric activity in Monaghan hospital – which in 1999 recorded 344 births – advised that consultant-led maternity services at Monaghan should be discontinued as the provision of such services was no longer supported by the recommendation of the Institute of Obstetricians and Gynaecologists. If proper consultant and paediatric services were available at Monaghan hospital for the people of Monaghan, the birth rate would have been at a level that would have ensured that a viable maternity unit could have been maintained.