FRESH fears were raised last night over the safety of critically ill patients at the country's smaller hospitals.
The probe by the Health Information and Quality Authority (HIQA) revealed Mallow General Hospital (MGH) in Co Cork did not have around-the-clock on-site senior consultants and facilities to manage patients with complex illnesses.
Jon Billings, director of healthcare quality and safety at HIQA, said it was "very concerning" that health bosses failed to learn from a previous damning review at another hospital.
HIQA also found the Health Service Executive (HSE) waited 14-months before it addressed issues in MGH after similar problems were raised at the Mid Western Regional Hospital in Ennis, Co Clare.
National recommendations were issued to HSE bosses two years ago.
The watchdog stated it was up to the HSE to reassure patients on the safety at similarly sized hospitals such as the facilities in Navan, Portlaoise, Roscommon and Nenagh.
"They need to carry out and conclude, as recommended two years ago, a systematic review of those hospitals to ensure the clinical risks associated with a smaller and sometimes stand-alone hospital are identified and addressed," Mr Billings said.
A spokeswoman for the HSE said the 20 new recommendations -- including 10 relating to accountability of the HSE -- would be in place by the end of this year.
It stated improvements such as those put in place at Mallow were being "implemented in the majority of similar-sized hospitals throughout the country" and longer-term improvements were underway.
The HSE said patients can be reassured of both safety and quality of services at MGH.
The HSE has introduced a mandatory policy for Cork University Hospital to accept critically ill patients from the Mallow facility.
A long-term reconfiguration of acute hospital services in Cork and Kerry will see complex cases dealt with at major hospitals, while MGH would deal with day surgery.
HSE Cork area manager Ger Reaney said they accept the HIQA report and "with the benefit of hindsight" might have moved faster in the wake of a previous HIQA report on Ennis.
Mr Reaney pointed out that within weeks of the HIQA report on Ennis being published in April 2009 it had appointed a clinical director.
The Mallow probe was sparked in August last year after the family of a patient provided information about critically ill patients with complex issues being treated at the Mallow hospital. The man later died at another hospital.
A letter from HIQA chief executive Dr Tracey Cooper to the HSE, from last September, also warned of their concern over the potential risks of people requiring emergency surgery at MGH while the permanent and temporary consultant surgeons were on leave.
Minister for Health, Dr James Reilly, said the report underlined the need for the HSE to recognise the implications in the previous HIQA report.