EMERGENCY departments in Dublin hospitals are under intense scrutiny for merger or closure as part of a major review.
Ian Carter, the HSE's national director for acute services, has confirmed a nationwide review is under way but has said restructuring the services in the capital makes most sense.
Dublin has three paediatric emergency departments and six adult emergency departments open around the clock, seven days a week.
Mr Carter's view that 26 hospital emergency departments is too many is backed by the Irish Hospital Consultants Association (IHCA).
It argues that the numbers of emergency departments open 24 hours is no longer sustainable or safe, and that rationalisation is necessary.
IHCA President Dr Denis Evoy has said that the number of emergency departments open 24 hours should be cut by half to around 14. Other departments might then operate on a 12-hour basis.
Dr Evoy accepts that while cutting the number might be politically difficult to implement, the public would have to be reassured that such a move would deliver better healthcare and services.
Patients, however, are concerned that overcrowding, not cutting the number of emergency departments, is the first priority.
The Irish Patients' Association points to the fact that overcrowding in hospital emergency departments jumped 30pc in the first three weeks of this year – leaving more patients on trolleys and chairs than when James Reilly took up his post as Minister for Health.
Mr Carter agrees that "by definition, any emergency department that is full of patients on trolleys makes care difficult to deliver. He insists, however, that the number of patients waiting on trolleys for beds had dropped 34pc in recent years.