Kenny's advisers knew of plan to shut Portlaoise
Taoiseach Enda Kenny's advisers were briefed on a confidential report recommending the downgrading of Portlaoise Hospital as long as a year ago - although it has never been published.
The report, commissioned by the HSE, recommended the 24-hour emergency department was not clinically sustainable and and also the removal of complex surgery.
The briefing document, dated July 3, and seen by the Irish Independent, was drawn up by the HSE and outlined an action plan to address immedate patient safety concerns.
On the same day the HSE's former Director of Acute Hospitals, Dr Tony O'Connell, in an email, referred to a "note from Flanagan I mentioned on the phone the other night".
Foreign Affairs Minister Charlie Flanagan's constituency includes Portlaoise Hospital.
A letter from Mr Flanagan to David Walsh, the HSE's Regional Director of Performance and Integration, said he had attended a crisis meeting of the board of Portlaoise Hospital.
"A most bleak picture was painted and grave dissatisfaction was levelled at the HSE for the complete absence of a plan for the hospital.
"It seems every department is in crisis and consultants are most fearful for safety of patients in the delivery of care."
He said that "morale is at rock-bottom, staff are both stretched and stressed, and nothing seems to be in place by way of reassurance."
He also made representations to the then Minister for Health James Reilly.
An investigation by Hiqa into Portlaoise Hospital, where five babies died, led to a damning report last May.
A plan on the future of Portlaoise Hospital, and how its A&E department may be downgraded, has now been put back until the autumn.
The matter is expected to become a bitter election issue as the Government and Opposition parties get into campaigning mode.