Health Minister Calls for Pause in Consultation on Emergency Surgery at South West Acute Hospital
The health minister has urged the Western Health Trust to halt its ongoing consultation regarding the future of emergency general surgery at the South West Acute Hospital (Swah). This move comes amid growing concerns over the potential permanent removal of the service, which has sparked public outcry and political debate.
Emergency general surgery was temporarily suspended at the Enniskillen hospital in December 2022. At the time, the Western Trust cited challenges in recruiting surgical staff as a key factor. As a result, patients from counties Fermanagh and Tyrone were required to travel to Altnagelvin Area Hospital in Londonderry, an hour and a half away. The decision to suspend the service was made to ensure public safety, according to the trust.
On 3 July, the Western Trust’s board agreed to consult on the possibility of permanently removing the emergency general surgery service from Swah. However, the Department of Health has now confirmed that Mike Nesbitt, the health minister, has written to the trust requesting a pause in the consultation process. A spokesperson for the department stated that while the consultation is a matter for the trust, any permanent changes would require the minister’s approval.
“The minister has been very aware of the ongoing and repeated challenges with the delivery of the recent consultation exercise,” the spokesperson said. “He engaged directly with the trust last week to discuss a number of concerns. Any change in service provision, especially any proposed permanent changes, must always be guided by a clear desire to deliver and ensure better outcomes.”
The minister has asked the trust to use this period to restore confidence by producing a vision plan that outlines how Swah will be supported to meet the needs of its current and future population.
Public and Patient Concerns
Concerns about the consultation process have been raised by the Patient and Client Council (PCC), which represents the interests of the public in the health and social care system in Northern Ireland. In a letter sent to the campaign group Save Our Acute Services (SOAS) earlier in July, the PCC expressed disappointment with how its early conversations with the trust had been reflected in responses to concerns, including in the media.
The PCC met with trust representatives on a single occasion in May 2025 to provide early advice on best practices for public involvement and engagement. However, the council felt that its input had not been adequately considered in the consultation process.
SOAS previously described the decision to consult on removing emergency general surgery as “absolutely disgusting.” The group has been vocal in its opposition to the potential loss of services, arguing that it could put lives at risk due to the distance and poor transport infrastructure.
A planned consultation event at the Killyhevlin Hotel on Tuesday was postponed. The Western Trust cited anticipated high attendance numbers and public safety concerns as the reason for the decision.
Political Response and Public Sentiment
Fermanagh and South Tyrone MP Pat Cullen welcomed the minister’s intervention, stating that it “comes as no real surprise.” He emphasized that the public felt their concerns and experiences were not being heard. “The onus is now on the Western Trust to rebuild public confidence and listen to them,” he said. “They also need to produce a plan for Swah that outlines how it will be supported to meet the needs of the community and the future population.”
Why Was the Consultation Taking Place?
The suspension of emergency general surgery at Swah in December 2022 was initially intended to be temporary. The Western Trust cited staffing issues as the primary reason for the suspension. At a trust board meeting in July, the board was told that it was “no longer possible to meet important safety standards” at the hospital.
Campaigners have argued that the loss of services, combined with the long distances patients must travel and inadequate transport options, poses significant risks to patient safety. Neil Guckian, the chief executive of the Western Trust, defended the decision, stating that it was “not a rushed decision” and that he understood the “strength of feeling” surrounding the issue.
“We have over two and a half years of working under these pathways, working effectively with no concerns on patient safety,” he added. Mr. Guckian also pointed out that evidence showed patients who go to Altnagelvin Hospital have better clinical outcomes and that no patient has come to harm.
What Is Emergency General Surgery?
Emergency general surgery involves treating patients with urgent conditions such as acute abdominal pain, infections, bleeding, and trauma. It includes procedures like gallbladder removal, appendectomy, and bowel surgery. If left untreated, these conditions can become life-threatening.
According to the Western Trust, Swah handled approximately five such cases per day. However, the trust argues that this volume is insufficient to sustain a dedicated emergency general surgical team.
The ongoing debate highlights the complex balance between ensuring patient safety, managing resources effectively, and addressing the concerns of local communities. As the consultation is paused, the focus now shifts to rebuilding trust and developing a sustainable plan for the future of emergency care at Swah.
