Rural lives "cannot be an afterthought" when it comes to health transformation, campaigners have said. In a joint "letter of concern" to the Northern Ireland Executive, four hospital campaign groups have called for a cross-departmental working group on rural health access. The campaigners have warned that rural communities "face the real threat of being cut off from timely access" to acute and other vital hospital services.
In 2024, former Health Minister Mike Nesbitt proposed a new hospital network which would see healthcare services spread and shared across counties, with patients expected to travel further for specialist treatment. The Department of Health has been approached for comment. Donal O'Cofaigh from Save Our Acute Services (SOAS), based in County Fermanagh, said it is "vital" that executive ministers collectively consider decisions about removing services from local hospitals.
SoS Causeway Hospital group, Save Our Services Daisy Hill and the Down Community Health committee were the other three groups that signed the letter. No time for new minister to fix health service warns top doctor Removing emergency surgery will create 'domino effect', campaigners warn 'Lives will be lost' unless services are restored at hospital For several years the groups have been campaigning against the closure of acute services in their areas. In their letter, the campaigners said that past healthcare decisions have been framed as "purely operational or clinical, with too little cross-departmental scrutiny".
After being temporarily suspended in February 2022, emergency general surgery (EGS) was permanently removed from Daisy Hill Hospital in Newry in 2024. Maternity services at the hospital could also be suspended from next month after the Southern Health and Social Care Trust said it was preparing for the "possible consolidation" of services to Craigavon Area Hospital from 23 November. In 2023, maternity services were permanently suspended at Causeway Hospital and consolidated at Antrim Area Hospital.
EGS was temporarily withdrawn from South West Acute Hospital (Swah) in Enniskillen in 2022. In July 2025, the Western Health and Social Care Trust's board agreed to consult on the permanent removal of the service from the hospital, but the public consultation was later closed after the trust agreed to "pause and consider". The health trust said it is now working with stakeholders "to develop a clear vision" for healthcare in the area, with EGS remaining suspended at Swah while this takes place.
Last year, the Northern Health Trust recommended providing EGS at just one of its hospital sites - meaning it's likely to be removed from Causeway Hospital. But the move cannot proceed without approval from Health Minister Robbie Butler, after his predecessor, Mike Nesbitt, resigned amid a party dispute over the proposal. O'Cofaigh said: "It's simply not good enough to allow services to temporarily [be removed] or collapse under pressures and then do nothing about it for years and just leave that as the situation." The groups called for a "presumption of restoration" - a pathway to restore services in cases where they were removed from rural hospitals without the appropriate assessments or scrutiny.
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