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A leading surgeon has said failing to modernise surgical services could risk making staff pressures and patient outcomes in Northern Ireland worse
It comes after Mike Nesbitt resigned as health minister following a row with UUP leader Jon Burrows over withdrawing emergency general surgery (EGS) from Causeway Hospital
A letter, signed by surgeons from across the UK and Ireland, said they felt they had no option but to intervene when it appeared politics not patient safety was influencing discussions around EGS provision
Surgeon Damian McKay said they are “concerned, disappointed and frustrated”, after the fallout
Those against the plan worry it could lead to other services being withdrawn
McKay told BBC News NI: “The key message should always be patient safety first and political votes second.”
He said failing to modernise could mean prolonging existing workforce pressures, limits access to care and widens inequalities in patient outcomes
The letter expressed support for planned changes including EGS as well as changes to rotas, improvements in ambulance access and making improvements to several areas to support patient services
The new Health Minister Robbie Butler said his decisions will be based on “expert evidence opinion” as well as the “voices of the people”
McKay, who is a general and colorectal surgeon at the Ulster Hospital, was speaking on behalf of the three surgical associations
Burrows had declared he would never support the withdrawal of the EGS service during a public meeting, a view Nesbitt said he only discovered by “monitoring the media”
The surgeons said “recent developments” risked further delaying the implementation of the 2022 review of EGS services in Northern Ireland, which recommended having the service at fewer sites
For almost two decades there have been serious issues around recruitment and retaining specialist staff in NI. That includes surgeons, nurses, anaethetists
Several informed and independent reports have over the years sited that NI has too many hospitals and not enough specialists to staff them
Surgeons have said that failing to make decisions about transformation has left vacuums in areas where the public say they feel ignored and under threat
Speaking on Good Morning Ulster, McKay said: “If you know that service reform can lead to a more stable, safer service, then we need to collectively work towards that to ensure patients get safe care and essentially that premise is well understood and well known
“It has taken place already throughout Northern Ireland and many other trust areas and I think the importance of this is really to show and support the services here, to do the right thing for patients.”
The statement is from surgeons from the Association of Coloproctology of Great Britain and Ireland, the Association of Upper Gastrointestinal Surgeons and the Association of Surgeons of Great Britain and Ireland
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In 2025, the Northern Health Trust recommended that EGS should only be provided at one of its hospital sites and that the service should move to Antrim Area Hospital
It said it wanted to prevent collapse and instead plan for change in the area
It is understood the Department of Health (DoH) was still waiting for a final recommendation to come from the minister
However earlier this month, more than 200 people gathered at Coleraine Town Hall to call on the health minister to stop EGS being moved to Antrim
Campaigners warned that it would create a domino effect leading to other services being withdrawn
Gemma Brolly from the SoS Causeway Hospital group said would keep fighting for EGS to stay
Speaking on Wednesday, after Nesbitt’s resignation, Burrows acknowledged the need for reform but said “how we deliver reform is every bit as important as what we ultimately decide”
He said “safe, sustainable services,” are the priority and reform must also address “health inequalities and regional imbalance, and recognise that people in different parts of Northern Ireland do not currently enjoy equal access to timely healthcare”
McKay, who is currently the medical director for cancer at the Northern Ireland Cancer Network SPPG which operates within the DoH, said the statement from the three surgical associations was significant and the first time they had come together
McKay said the statement was published to show that the “reform process has been going on for almost two decades”
He said teams currently providing this care are “under significant strain and significant pressure and that would only worsen I believe with prolonged delay in terms of decision making”
“The whole executive needs to take some collaborative ownership with regard to health.”
Speaking to BBC Radio Foyle’s North West Today on Monday, deputy chair of Stormont’s health committee and Alliance MLA Danny Donnelly said the letter was a “highly significant intervention from those surgical associations, who are very clear on the risks involved and the risks involved in not making these decisions
The Belfast and South Eastern health trusts have each consolidated EGS on one site and have completed this part of transformation. But the issue remains unfinished and contentious in the Western, Southern and Northern health trusts
McKay said surgeons want the best for their patients and when a vacuum is allowed to develop services become fragile
“For a population of 1.9 million, three centres performing emergency general surgery would be commonplace in other parts of the UK and the world,” he said
It is thought if Northern Ireland had a blank hospital canvas those three sites would be at Altnagelvin, Craigavon and Belfast
McKay said running too many emergency surgeries on too many sites also had an adverse impact on cancer waiting times
He said the same surgeons were dealing with EGS and cancer operations, which wasn’t efficient
“When we attend UK council meetings, surgeons from Northern Ireland are disappointed, even shocked, at just how behind Northern Ireland is compared to the rest of the UK when it comes to how we deliver care – our waiting times especially around cancer are among the worst,” he said
In the run up to next year’s local election, the surgical associations are warning MLAs to think of the entire health population of Northern Ireland and not just what is happening in their own political patch
Speaking to BBC News NI on Friday, Butler said that he would work to convince people that “any changes that come, wherever that may be, is made in the best interests of the people”
“But the people need to also be at the centre of any decisions that are made,” he added
Butler said he felt there was a “disconnect” between the medical officials and the people who are going to be affected by changes to Causeway Hospital
“What my job is at the moment is to try and repair that disconnect and then take my time not to make a hasty decision but to make the right decision, and that’s my promise to the people of Causeway.”
He said any changes or improvements “need to be sustainable and deliverable”
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