The Health Information and Quality Authority has said its statutory reports into Ennis and Mallow hospitals identified serious concerns for patient safety at these and similar sized hospitals.
In a statement, explaining the background to its role in the wake of major political controversy over the Roscommon emergency department closure, the authority said further procrastination and delay is not acceptable and can put patients' lives and safety at risk.
It says its reports contain a series of recommendations aimed at improving the system that should be implemented in full.
HIQA says it has not recommended the closure of any hospital and that small hospitals have a pivotal role in providing a range of safe services to their communities.
The authority says it is the duty of the Board of the Health Service Executive to oversee the implementation of the recommendations contained in the Ennis/Mallow reports and HIQA will continue to hold the HSE to account in doing so.
HIQA says its 2009 investigation report into Ennis followed serious concerns raised by family members following the deaths of two patients.
It recommended that the HSE review services in all hospitals with a similar profile to Ennis.
The HSE later identified the following ten hospitals in its review: Our Lady's Hospital Navan, Louth County Hospital, Midland Regional Hospital Portlaoise, St Columcille's in Loughlinstown, Ennis, Nenagh, Roscommon, St John's Hospital in Limerick, Mallow General and Bantry General.
HIQA said that towards the end of June, the HSE told the authority it had serious concerns regarding the range and type of services provided at Roscommon County Hospital that reflected the risks to patients in small hospitals previously identified in the Ennis and Mallow reports and compounded by a shortage of junior hospital doctors.
A meeting of the Fine Gael parliamentary party called to discuss the controversy over hospital closures took place tonight.
A number of TDs had been sharply critical of Minister for Health James Reilly and the Government's communication strategy on the issue.