A US neurosurgeon's offer of $4 million worth of key medical equipment for the west's first neurosurgery unit is "hanging by a thread", due to the Department of Health's reluctance to accept the offer.
Ms Pat O'Dwyer, envoy for Mr Patrick Kelly, professor of neurosurgery at New York University, says she is mystified at the Government's attitude, given that the west of Ireland currently has no neurosurgery unit.
"Eighty per cent of neurosurgical admissions are emergencies, which have to be seen immediately. So many lives could be saved, so many brain injuries with consequent and very costly lifelong care avoided at savings to the Exchequer if this unit was established," Ms O'Dwyer says.
Irish-American support for the initiative is becoming harder to sustain in the wake of the many charity demands that followed the September 11th disasters of 2001.
Prof Kelly's offer of the specialised equipment - and of further funding from the Irish-American community - dates back three years and is contingent on capital funding to include a neurosurgical unit in the current phase-two development at University College Hospital, Galway. Current national policy provides for this specialist treatment at two locations only: Beaumont Hospital in Dublin and Cork University Hospital.
The proposal has been backed by the Western Health Board, which first made the case for a neurosurgery unit in the region in 1989.
However, the Department of Health has referred the issue to Comhairle na nOspidéal, which is carrying out a review of neurosurgical services.
The review is not expected to be completed before next spring, after the December budget when there might be an opportunity to sanction approval for the hospital unit.
The case for the west is complicated by opposition within Beaumont Hospital to any extension of neurosurgical services elsewhere.
Patients "from Donegal to Leitrim and further south" stand to benefit from location of this unit in Galway, Ms O'Dwyer says. "We are talking about the difference between returning people back into their communities, and long-term taxpayer-paid care. In this sense, neurosurgery is just about the most cost-effective surgery you can find."
Ms Pam Fleming, chairwoman of the Western Neurosurgery Campaign, says the population growth in the west supports the demographic argument for a neurosurgery unit at Galway.
Galway's population has increased by 14.9 per cent in six years, and the maximum catchment area now is over one million.
Ms Fleming's son, Sammy (26), needs long-term care at home following serious injuries he sustained in a road accident. Ms Fleming knows that had her son seen a neurosurgeon on the night in question, his life might have been different. "Sammy is a casualty of the lack of a proper health service," she acknowledges. "We want to get those first few hours right for other people who may be victims of trauma."