A medical consultant says sanctions are the only way to deal with overcrowding in the country's Accident and Emergency departments.
Chris Luke was responding to concerns being expressed in a letter to HIQA from trainee doctors - who say conditions are "unequivocally dangerous".
Twenty-four members of the Irish Emergency Medicine Trainees Association are calling for the HSE and Government to implement the recommendations of a report that HIQA published on overcrowding in May 2012.
Mr Luke is a consultant in Emergency Medicine in Cork. He agrees with everything the trainees are saying about conditions at the two departments where he is based being appalling.
He said: "It's really very important that we stop quibbling over statistics; it can be terribly upsetting for staff and patients when they're told that their reality is not the same as the public, the acceptable, political reality.
"The only thing that seems to work with this difficulty - this perennial issue of congestions - is when you bring in the risk managers and you impose really quite severe sanctions on those who are in charge."