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Background: The first merging of small hospitals into a large one came into existence in January 2005 in county Louth. As a result the surgical departments of Louth county hospital Dundalk and Our lady of Lourdes hospital Drogheda Ireland were combined. Two hospitals are at less than half an hour drive and situated North-eastern region of Ireland. Objectives: To assess the impact of joining two departments of surgery in two different hospitals along with the patient's reaction after such arrangements were made. Design: review of literature. Setting: Louth County Hospital Dundalk Ireland. Period: One year Methods: Following review of literature it was decided to explore the experience of patients who were treated in Louth County Hospital Dundalk one year after merging of two departments of surgery. Randomly 20% of patients treated in Louth County Hospital were included in a telephone survey. These patients were under care of all consultant surgeons. The patients were asked about their experience in Louth hospital. Also impact of joining surgical departments on waiting list was explored. Results: Out of 1310 patients, 20 % of patients treated in Louth Hospitals were included in the survey. The age of the patients varied from 15 to 67 years. 57 % of the patients were female and the remainders were males. It was found that 93.5% of patients were happy to travel to Dundalk and 96.5% were satisfied with the facilities there as well. Furthermore 96% said that they would be happy to have surgery in Dundalk if they ever needed it in the future. 6% of patients were dissatisfied with services in Louth County Hospital, Dundalk. Conclusions: The improvement of quality processes in healthcare is of constant concern to communities throughout the world. The results have clearly demonstrated that restructuring of services can work well and be acceptable to patients once hospitals are prepared with relevant resources in place. [ABSTRACT FROM AUTHOR]