There has been an angry reaction in the northeast to the latest plans by the Health Service Executive to centralise some services at Our Lady of Lourdes and Cavan General Hospitals.
The plan will see an end to acute inpatient care in Monaghan General and an end to major surgery in Navan within months.
A new internal HSE document maps out the future for the health services in the troubled northeast region.
Transformation - as the programme is called - is supposed to conclude with a new regional hospital, but in the meantime major services are to be removed from some hospitals and centralised at Our Lady of Lourdes in Drogheda and Cavan General Hospital.
According to the 69-page report, it is expected that all medical, surgical and critical care cases will be treated in these two hospitals within the next two to three years.
The report also reveals that all acute inpatient care will end in Monaghan by the end of November, with patients instead being brought to Cavan. All major surgery will end in Navan by September while out of hours emergency surgery in Louth County Hospital in Dundalk will cease by July.
The report also talks about increasing the number of ambulances and staff, as well as building medical assessment units in several hospitals to treat patients there.
However, the report stresses repeatedly the lack of extra money to carry out this work.
Campaigners in Monaghan say the last time the hospital went off call there 17 people died. They are warning these changes will mean the same thing will happen again.
