Four consultants at the centre of the Waterford hospital morgue crisis had warned, in a second letter in March, they may have to cancel services to the hospital over its morgue scandal.
Consultant pathologists Prof Rob Landers, Dr Fergus MacSweeney, Dr Nigam Shah and Dr Christine Shilling threatened to scrap services on March 26 after criticising the "inordinate delay" in responding to their initial concerns.
Files released today to Sinn Féin's David Cullinane showed that despite writing to the HSE's South/South West Hospital Group chief executive Gerry O'Dwyer on October 18 to raise morgue concerns, his response was not received until March 25.
On receipt of the response, the consultants wrote again to advise the significant wait in responding to the issues raised had amounted to an "inordinate delay" and did not inspire confidence.
"Continuing failure to provide safe and dignified conditions will give us no option but to withdraw our post-mortem service from the current facility," they wrote.
"Contingency arrangements will need to be put in place for this eventuality.
"While we have no desire to discommode patients and their relatives, the failure of the HSE to adequately progress the provision of new safe facilities leaves us with no other choice.
"The safety of our staff and public, as well as the dignity of the deceased, remain our only concerns.
"These matters must be resolved quickly and without further obfuscation or delay," the consultants also warned.
The threat to remove morgue and pathology services from Waterford hospital due to a behind-the-scenes crisis had not been referenced by any HSE, hospital or Government figure until the letter was published yesterday.
A PR statement from the hospital on Monday last claimed it had not been made aware of any complaints.
Meanwhile, a separate letter - also published today - highlighted the fact that problems at the Waterford hospital morgue were known at senior HSE level, with the health system's second highest ranking official in the southern region specifically flagging the concerns last summer.
In a short letter sent on July 12 last year, the hospital group's assistant chief executive Dr Gerard O'Callaghan said he had recently visited the mortuary "at the request" of hospital management.
Writing to the HSE Estates unit - which deals with capital projects and new builds which should be funded and prioritised - he said: "I would have to say that I was appalled at the poor condition of the building and the obvious health and safety and infection issues that exist there.
"The working conditions for the staff are not acceptable, nor is it a suitable environment for relatives of the deceased.
"I am aware that the development of a new mortuary has been a priority for hospital management for a number of years and they have included the current mortuary as a risk on their risk register.
"I believe it is now imperative that this development would be given priority by the HSE estates department."
The second consultants' letter from March 2019 and the clear concerns outlined by senior HSE personnel in the July 2018 correspondence are likely to place further pressure on Government and the HSE hierarchy to clarify what exactly was known about the morgue scandal.