ONE-in-three accident and emergency (A&E) departments may have to close or restrict operations due to the combination of the ongoing water crisis and staffing shortages.
The stark warning came as Dr Chris Luke, A&E consultant at Cork University Hospital, said that struggling A&E departments also face a flood of swine flu cases over the next fortnight as the end of the Christmas and New Year holidays sparks a likely national spread of the virus.
A&E units have already been battling over the past month to cope with a bout of a debilitating winter virus that, while not swine flu, can involve a serious chest infection, which, if neglected, can turn into pneumonia.
Dr Luke said that A&E units were now fighting an increasingly difficult battle to maintain service levels despite ongoing water problems and resource issues.
"The water problem is an issue of serious concern for all of us at this stage," he said.
"I am really very concerned that about a third of (A&E units) may have to close in two weeks' time," he said.
"We have about 30 A&E departments in Ireland and I am really very concerned about one-third of them."
Dr Luke acknowledged that local authorities were working hard to address the water distribution crisis sparked by the Arctic weather and hundreds of fractured water pipes.
Leaks in hospital supplies have been given priority by councils -- and, where pipe repairs are ongoing, water has been delivered by tankers to hospitals.
A HSE spokesman said: "We're not getting any sense that A&Es are in trouble. We're managing the situation and hospitals are working with local authorities.
"Some hospitals have hired tankers, and we're supplying bottled water to others."
But Dr Luke said that hospital operations were crucially dependent on water supplies -- and that water usage actually increased at this time of year rather than decreasing due to the demands of various winter illnesses.
The consultant said that the water problem came as just another headache for A&E units already battling to maintain services despite resource and recruitment problems.
"The annual (hospital) changeover is now on January 11 this year rather than the traditional January 1. It won't be until we see how many doctors actually turn up on January 11 that we know how badly off we are," he said.
Dr Luke added that, since last summer, A&E units have struggled to cope with staffing issues linked to the recruitment of junior doctors.
In a four-month period last summer, emergency departments lost somewhere between 300 and 400 foreign medical staff and they have struggled to fully replace them since then.
In some cases, A&E units were almost forced to restrict services over the shortage of junior doctors and locums.
Last September, a total of 270 non-consultant positions were still vacant in various Irish acute hospitals.
"There are grave difficulties in staffing the departments and teams are stretched thinner and thinner," Dr Luke said.
"It's been coming for years and the powers that be were warned well in advance, but now we find ourselves in a very serious situation.
"We could fill the gaps partially with interns -- first-year doctors.
"There is an opportunity here to not export them but use them in A&E departments," he said.
While Irish health budgets are coming under increasing pressure due to the fiscal crisis, foreign countries -- particularly in the Middle East and Asia -- have launched aggressive recruitment campaigns for experienced junior doctors.
The attraction of working abroad has been further enhanced by the inability of many foreign junior doctors to secure long-term contracts in Ireland.