was due to commence earlier this year but has now been postponed until April 2008 at the earliest. The World Health Organisation recommended the commencement of this programme seven years ago and the National Immunisation Committee has been working with the government to get it started here nationally.

Western area A hospital has put a stop to blood tests being done on a Sunday, which facilitates patient discharge on Monday. This is to prevent having to bring in lab technicians at the weekends.

Southern area Three scheduled nursing-home inspections had to be cancelled due to non-availability of a locum cover for a member of the inspection team.

Cork area:

Four years ago, a rehabilitation unit was built for the elderly in the Cork area but only half the unit was opened at the time. The full opening was scheduled for September 2007 to cope with an expected increase in demand for winter. The HSE cancelled the opening due to cutbacks, with the result that recruitment for staff will have to start all over again . . . a process that could take up to a year.

Funding had been allocated for an extra nurse for Cystic Fibrosis services but now this appointment has been delayed. Cystic Fibrosis services in the Cork area have been historically under-resourced.

GP Practice: A 73-year-old woman with newly diagnosed bladder cancer who previously had breast cancer is living alone and is dependent on social welfare. She suffers from early dementia. She requires 20 sessions of radiotherapy and is considered to be unfit to attend the sessions alone but the ambulance service has informed her GP that she is "on her own" due to cutbacks.

Mercy University Hospital: The new A&E unit remains closed. It was due to open earlier this year but now will not, due to the recruitment ban. The current A&E was described as being unfit for humans in a previous A&E report.

A physiotherapy position previously approved to support a pulmonary rehabilitation programme for patients with chronic lung disease has been frozen. This leaves the entire rehab programme under threat.

A member of the rehab programme has also given notice to leave. Due to the recruitment ban, this post cannot be advertised. Therefore the service will be without a team member, which is catastrophic for the department.

A GP seeking an urgent appointment for a patient was told there are no outpatient clinics this week.

South Infirmary Hospital: Intensive Care Unit nursing staff who were on leave were not replaced . . . as a result three free beds in ICU could not be used and patients in A&E who required intensive care had to remain in A&E until the night staff came on duty.

Locum cover was refused for the dermatology department, resulting in cancelling patients' appointments and longer waiting lists. The current waiting list is nine months.

Dublin Area:

St James's Hospital: The hospital had managed to get the number of patients awaiting long-term care (LTC) beds down from 130 to 30. The cutbacks have now ceased funding for two essential factors in maintaining this scheme . . . funding for private nursing home beds and homecare grants.

As a result, the number of patients waiting for LTC beds has tripled again, up to almost 100 patients. This will N1 undoubtedly worsen as the winter progresses. The hospital is already seeing effects in terms of cancellation of elective surgery, the reopening of an area called the transition unit for incoming patients and shortage of phlebotomists in out-patient departments. There should be five outpatient phlebotomists but currently there are only two, resulting in delays in blood tests.

Connolly Hospital, Blanchardstown:

There is no locum cover in rheumatology/general medicine for a doctor on sick leave . . . the number of patients that can be seen has had to be reduced and waiting times for appointments has already lengthened.

Adelaide and Meath Hospital Dublin, incorporating the National Children's Hospital: The waiting time for testing has gone from two weeks to four months. Developments for the stroke unit were at an advanced stage after six years of planning . . . but these developments have now been cancelled.

The Rapid Access Clinic is just about remaining open. A clinic in the geriatric department has been cancelled. Staff are not being replaced in the gastroenterology department.

Our Lady's Hospital, Crumlin: Although approval was recently secured for a part-time dietetic support for the neurology department, this has now been blocked. This specialist provides first line treatment for rare forms of epilepsy and without it patients suffer seizures on a daily basis.

Clontarf Orthopaedic Hospital: The Varicose Vein Clinic is now closed due to the ban and nursing staff who recently retired are not being replaced.

GP Practice: A patient was due for knee surgery in Cappagh Hospital this month. She agreed to a suggestion by an NCHD to participate in a pre-op exercise programme that would assist her recovery. Twelve hours before she was due to start the programme, she received a call to say it was cancelled due to lack of funding. She was then informed her planned surgery this month had also been cancelled.

GP Practice by Liberties Primary Care Te am : Several hundred elderly patients have had their standard of care immediately reduced due to the non replacement of a Public Health Nurse.

Co Meath Our Lady's Hospital, Navan: Closure of orthopaedic unit.

Co Kilkenny St Luke's, Kilkenny: Threatened closure of rehabilitation units.

Co Westmeath:

Mullingar Hospital: Intensive Care Unit and Coronary Care Unit closed to admission due to staff shortages.

Physicians have been asked to cut back day-case procedures by 50% and out-patient department visits by 30%.

Five medical beds and six surgical beds have been closed as consequence of the cutbacks.

No replacement of departing staff.

Tipperary area Clonmel Hospital: Closure of a surgical theatre.

Nenagh Hospital: Widespread nonreplacement of staff.

South Tipperary General Hospital, Clonmel: Surgical theatre closed and surgical activity reduced to one-third of regular activity.

Doctors are expressing serious concerns about the refusal to recruit locums on medical staffing levels in the emergency department.

Louth area Loss of immunisation nurse in the area, meaning the uptake of vaccines in Co Louth is likely to fall behind neighbouring counties and there will be a higher risk of disease occurring.

Kerry area Home Help: Hours have been reduced in the area for the vulnerable and elderly. Some patients may need to be admitted to hospital if they do not get adequate support at home.

Mental Health Services: A locum position has not been ratified for a critical frontline post.

Limerick area Limerick Regional Hospital: There is non provision of locum cover which is threatening to curtail transfers from Limerick Regional Hospital to the rehabilitation centre in St Ita's.

Mid-Western Regional Hospital: The HSE has refused to provide locum cover for non-consultant hospital doctors or consultants at the Department of Ear, Nose and Throat . . . Head and Neck Surgery.

Co Galway University College Hospital, Galway:

There is an imminent threat of the closure of wards due to 45 nursing vacancies. Due to the recruitment embargo, the effect will be a reduction in bed availability and more patients on trolleys in the A&E department.

The appointment of an infection control nurse is not being progressed, with consequences for MRSA.

One surgical intern is doing the work of two, due to no locum cover. There is also a threat of no overtime pay.

GP examinations in the hospital have been dramatically reduced.

There are six vacant radiographer posts from an allocation of 42. This has led to limited services in the following areas: there was no scanning on the second CT for around two weeks; the screening room is now closed in the mornings; the IVP room is closed in the mornings.

Since the end of last month, the Department of Cytology has been unable to provide a diagnostic gynaecological cytology service to the population of both the west and southeast . . . a result of the recruitment ban.

Co Sligo Sligo General Hospital: Four consultants in surgical and obstetrics are to be laid off due to cutbacks.

Co Mayo Swinford District Hospital, Mayo: Three physiotherapists to be let go.

Co Roscommon Roscommon County Hospital: The xray department has provided excellent walk-in services for all routine x-rays, with reports arriving to GPs either the next day or day after. However, due to the non-availability of locum cover for a radiologist, they are now often delayed by up to 10 days.