A HSE report into hospital services in the Mid-West has recommended that 24-hour A&E services be provided by only one hospital in the region.
The report recommends that full A&E services in the region be retained only at the Mid Western Regional Hospital in Limerick.
It says that 24-hour A&E services at Ennis and Nenagh Hospitals are to be replaced by Local Emergency Centres and Medical Assessment units.
The report says many patients attending A&E units to date could have been more appropriately dealt with by a GP out-of-hours service.
In a statement, the HSE says the existing hospital structure was poorly configured.
However, Labour has criticised the Executive for not publishing the report earlier to facilitate public debate on the changes.