HEALTH Minister Micheal Martin was given a clear warning by hospital chiefs at Our Lady's Hospital in Crumlin that government cutbacks were leading to the cancellation of crucial operations for children - five weeks before the tragic death of baby Roisin Ruddle.

Two-year-old Roisin died at home in Limerick just hours after her scheduled heart operation at Our Lady's Hospital had been postponed due to a shortage of intensive care nursing staff.

The Sunday Tribune has established that in late May, just over a month before Roisin's death, senior hospital authorities at Crumlin wrote directly to the minister following representations made by his office about the cancellation of surgery for another girl.

The acting chief executive of Our Lady's Hospital told the minister in a letter dated 23 May that the intensive care facilities at the hospital were under pressure and specifically blamed government cutbacks.

"Due to the capping of employment ceilings in December 2002 and to funding problems, it is not possible to open five high-dependency/ICU equipped beds thus putting pressure on the 16 available ICU beds, " the hospital acting chief executive told the minister.

Following the death of Roisin at the beginning of July, Martin demanded an immediate report on the cancellation of her surgery from the Eastern Regional Health Authority, which oversees services in Dublin.

The report, which is revealed by The Sunday Tribune this weekend, shows that the postponement of surgery for young patients at Crumlin for non-clinical reasons was becoming commonplace by the end of June.

The report discloses that the cancellations of scheduled operations were running at around two per month in the first six months of the year.

"Five postponements related to the surgeon being unwell and seven related specifically to the absence of an appropriately staffed ICU bed, " the report states.

The ERHA report was given to the Ruddle family in mid-July and after representations from them that the minister establish a special three-person review group to look further into the controversy. The group is to have its first meeting in Crumlin next Thursday morning.

The report reveals that the hospital recruited 35 overseas nursing staff to work in intensive care over the last year, but that nine of these have already left and more may follow.

"One important problem faced by the hospital is that many of the nurses are married, however, spouses do not have an automatic entitlement to work in Ireland.

Reports indicate that approximately six nurses are considering moving to Britain as a result."

Department of Health sources said this weekend that significant money had been given to Crumlin to hire nurses in 2001, but that these had not been recruited.