Lack of segregation from other patients creates significant risks of cross infection from superbugs such as MRSA, said the author of the report, Dr RM Pollock.
St Vincent's University Hospital in Dublin, the National Adult Cystic Fibrosis Referral Centre, comes in for the heaviest criticism. It also treats almost 60% of the country's adult cystic fibrosis sufferers.
"Segregation from an infection control point of view is difficult, and the social mix of young CF patients and elderly patients is very unsatisfactory," Dr Pollock said.
The British expert in delivery of healthcare services warned if there was an outbreak of a virulent organism at the hospital, it could lead to litigation similar to that which surrounded the Hepatitis C infection scandal.
Dr Pollock also found "dangerously inadequate" staffing levels within cystic fibrosis, at more than 400% below the minimum accepted standard. There are less than the equivalent of four consultants treating more than 1,100 patients with cystic fibrosis in Ireland there should be 29.
Controversially, Dr Pollock recommended cystic fibrosis services be shut down at four of the 13 centres.
"Clearly the locations at Tralee, Mayo, Sligo and Drogheda have insufficient workload to justify the clinical establishments needed to ensure first class service," Dr Pollock said.
The review was commissioned by the Cystic Fibrosis Association of Ireland (CFAI) and carried out during 2003/2004. In light of its findings, the Association wants the Government to take urgent action in four key areas:
The implementation of a national cystic fibrosis service delivered through nine specialist centres. Excluding St Vincent's, this will involve an estimated investment of €13.5 million and €9 million annually for extra staff.
An estimated €8 million investment in facilities at St Vincent's Hospital.
The establishment of a Microbiology Reference Laboratory.
The establishment of a Neonatal Screening Programme for early detection and treatment and longer life for patients.
Commenting on the report's findings, Chairman of the CFAI, Carl Rainey, said the report was the blueprint for the future of cystic fibrosis services in Ireland. He called on Tánaiste and Health Minister Mary Harney to recognise the crisis within cystic fibrosis and take appropriate action.
"We also know that the death rate among people with cystic fibrosis is intrinsically linked to facilities and specialist staff and Ireland displays a much higher death rate than does England, Wales and Northern Ireland," Mr Rainey said.
He said patients needed services that minimised the potential for cross infection as well as access to appropriate staff.
"These are not luxuries. They are rights. There are entitlements. They are lifesaving necessities," he said.
The Health Service Executive (HSE) yesterday welcomed the report's findings. Director of the HSE's National Hospital's Office, Pat McLoughlin, said he would immediately establish a working group to examine the report and its recommendations.