The people of Tuam, Co Galway, have appealed to the Minister for Health, Mr Martin, to avert the closure of a private hospital. Three western counties will be affected by the loss of the Bon Secours Hospital, better known as the Grove, and its absence will increase pressure on an overloaded public health system, according to the newly formed Tuam Hospital Action Committee.
The Western Health Board is to hold a special meeting on the closure on Friday.
Chaired by Dr Mary Waldron, a Tuam GP, the action committee has proposed that the hospital be taken over by the State, through the health board, for development as a district or community hospital for north Galway/south Mayo/west Roscommon.
The committee says this would be of direct benefit to a high percentage of elderly in the area who do not necessarily require the full resources of an acute bed in University College Hospital, Galway (UCHG) when ill with a condition such as flu.
The recent announcement that the hospital is to shut after more than 50 years' service by the French order of nuns came as a "devastating blow" to the town, according to Dr Waldron.
"Shattering" was how the Archbishop of Tuam, Dr Michael Neary, described it. "Tuam, with its expanding population, needs a hospital," Dr Neary said in response to the announcement early this month. "I find it impossible to view this occurrence as anything other than a major reverse for the development of the town."
It is understood the decision was taken for commercial reasons by the Bon Secours hospital management, which owns the former Galvia private hospital in Galway.
Some of the 45 non-religious staff are expected to seek transfer to the Bon Secours in Galway, while others are expected to be offered redundancy.
The move comes at a time of mounting concern over centralisation of certain public health services in the west - such as breast cancer treatment, as reflected in last Friday's protests in Mayo - and further entrenchment of a two-tier system, with plans for a £60 million private hospital at Doughiska, near Merlin Park hospital, Galway.
Seen as a small general hospital with provision for routine surgical treatment, the Grove had been experiencing a decline in patient numbers over recent years.
In its early years, it met the needs of all sections of the community, including maternity, and the Western Health Board used to pay a small daily subvention towards the upkeep of public patients.
Recently, the order initiated discussion with the Western Health Board on a possible takeover. The board agreed that an option appraisal should be conducted to assess the capital costs of a greenfield development, adaptation of the Bon Secours hospital, or an extension to Aras Mhuire, the health board's existing 25-bed community nursing unit in Tuam.
The appraisal was based on both a 50bed and 60-bed community hospital option for older people, and it was felt that Aras Mhuire offered a capital and operational advantage, according to the health board's chief executive officer, Dr Sheelah Ryan.
The board did express an interest in acquiring the adjoining lands for health service developments in the Tuam area.
Dr Waldron says the health board plans to develop Aras Mhuire bear no comparison with the options offered by retaining the Grove.
"Even after the health board subvention for public patients was lifted, we would still admit some elderly and the nuns charged a reduced rate," she told The Irish Times.
"We have also had a hospice bed there, sponsored by Tuam Cancer Care, which has been a fantastic facility, with a lovely atmosphere for both patients and relatives."
The generosity of the nuns has been praised by Ms Margaret Feely, a trained public health nurse and chairwoman of Tuam Cancer Care.
"You might have a patient who needed a commode or back rest, and strictly speaking this was the responsibility of the health board. But you could always rely on the Grove to help you out.
"It has also been invaluable for respite or palliative care in terms of proximity to a patient's home."
Apart from serving the elderly, the action committee believes that the hospital could be used as a centre for respite care of dependent patients, such as those with chronic illnesses like Alzheimer's; as a "step down" facility from UCHG for semi-acute and/or convalescent-type patients, to ease pressure on the Galway hospital; as a possible "GP on call" centre for emergency after-hours care; and existing facilities in terms of nursing, physiotherapy and radiology could be developed.
Dr Waldron and her committee, representing hospital staff, fellow GPs, pharmacists and concerned residents, hope that the Minister will realise that closure would be retrograde.
They hope that he and his Minister of State, Dr Tom Moffatt, will recognise the need for district hospitals to complement the provision of high-technology medicine in the west.