'People are prepared to travel for specialisms' - health minister

Health Minister Mike Nesbitt says that survey work shows the "vast majority of people" are prepared to travel if they are going to get to an area of specialism

The Health Minister Mike Nesbitt said that the "vast majority of people are prepared to travel for healthcare if they are going to get to an area of specialism for what they need".

A consultation - which began in October and closes on Friday - has been gauging public opinion on plans for a new hospital network.

Equal access to healthcare across Northern Ireland and ensuring services are convenient for older people are among public concerns over the plans.

The proposed plans would see services spread and shared across counties and patients expected to travel further for specialist treatment.

The Health Minister Mike Nesbitt told BBC News NI that specific proposals will be brought forward by the trusts.

"What we need to do is stop thinking about hospitals in isolation. We need to start thinking about hospitals as a network," he said.

"We need to recognise that not every hospital will offer every procedure. We're going to have areas of specialism. Once we establish the principle that it's going to be a network then we will go on to talk about the specifics about different services.

"We've done some survey work which says the vast majority of people are prepared to travel if they are going to get to an area of specialism for what they need."

The Department of Health (DoH) said the consultation was not about proposed service changes and that any reorganisation would be subject to engagement with local communities.

'Unfair assessment' - health minister

Some of those who took part in public meetings told BBC News NI that people living in rural areas must not be treated like "second class citizens".

Others said they had "no trust in management" and called the consultation a "tick box exercise".

The Health Minister told BBC News NI that describing the consultation in this way is an "unfair assessment".

"I have engaged face to face on a personal basis with some of these campaign groups around Daisy Hill and the South West Acute Hospital.

"I've been listening to them and I would encourage them to engage more."

A DoH spokesperson said the consultation had "successfully facilitated engagement across NI and contributed to the vital debate on the future of health and social care services".

"The purpose of the reconfiguration framework consultation is to seek views on how our hospitals can cooperate more effectively as a network to best serve the population," they added.

'Second class citizens' - campaign group

Public bodies have a legal duty to consult the public when they are proposing to change how and where services are delivered.

The consultation looks at why hospitals need to be reconfigured or changed and how the proposed new system would be managed as an integrated network.

It is also looking at what particular medical services could be delivered at particular locations and the timing of reviews which could lead to changes in the future.

Helen O'Sullivan - who lives in the Western Health Trust area and is part of the Save Our Acute Services campaign group - said the people of County Fermanagh should not be treated as second class citizens and should have access to emergency general surgery at the South West Acute Hospital (Swah) in Enniskillen.

Helen O'Sullivan said those in rural areas should have access to emergency general surgery

People living in the Southern Health Trust have said that if Daisy Hill hospital is downgraded further, lives will be placed in jeopardy.

Francis Gallagher from the SOS Daisy Hill Campaign group said rural areas were being forgotten about.

Francis Gallagher is from the SOS Daisy Hill Campaign group

What would the hospital network look like?

The proposed new network would retain the current model of four categories: Area, general, local hospitals and regional centres.

• Area hospitals are NI's largest hospitals, offering emergency and planned treatment, with 24-hour emergency departments, paediatrics, obstetrics, specialised clinical teams and critical care

• General hospitals would include unscheduled (unplanned for) care, but geared to a specific more isolated geographical location. These hospitals will compete with the area hospitals for resources

• Local hospitals would continue to offer a broad mix of community services including diagnostic and mental health support, but if they are to remain open, they will have to justify that they meet their population's needs and are cost effective

• Regional centres would deal with the likes of breast cancer, strokes, cataracts, and neurology, with the aim of reducing hospital waiting times

Reshaping the hospital network has been debated for decades, but Nesbitt insisted this was the first roadmap aimed at a clear path to recovery for services.

Change requires potentially difficult political decisions.

While the document does not pinpoint where all the new medical speciality hubs will be located and which services or even hospitals may close, it does spell out that "all hospitals will not do all things".

Nesbitt said it was not about cost cutting or closing hospitals but "ensuring effective use of space and resources".

Health Minister Mike Nesbitt said the plan was not about closing hospitals

Some critics have said the document does not come close to informing the public about what those changes might mean.

It does not spell out specific changes, but hints at services being more streamlined and travel essential if patients want a timely diagnosis.

Gemma Brolly - who lives in the Northern Trust and is part of the SOS Causeway Hospital Campaign group - said the needs of an ageing population were critical.

"All we ever hear is about our older population on the north coast, and yet if we continue to take services away and centralise services in other trusts, how are those older people going to reach those places?" she said.

Concrete proposals needed

Neil Johnston, public affairs and policy manager at Northern Ireland Chest Heart and Stroke, questioned whether the plans were "anything more than rhetoric".

He told BBC News NI's Good Morning Ulster the document had lots to consider but few timescales and actual proposals.

Dr Owen Finnegan, a retired consultant physician at Causeway Hospital, said he thinks the change "is going to make things worse rather than better".

He said people will accept travelling further for specialist care when it's elective and planned but it is "totally different when you have a life-threatening emergency in the middle of the night which requires urgent and emergency care".

What is the argument for change?

According to the DoH, staff are stretched across too many hospitals, which causes services to collapse.

Centralising would create a more resilient service and properly managed change should in time deliver savings, it has said.

That network would deliver unscheduled, elective and community hospitals across Northern Ireland and - according to the DoH - make the best use of existing buildings.

The locations of the general hospitals of Swah, Daisy Hill in Newry and the Causeway in Coleraine, and the services they will deliver, is perhaps the most contentious area of the plans.

There has been public opposition to changes and proposed moves made to emergency general surgery and maternity services at these sites.

Their geographical locations and challenge of maintaining rotas are their biggest challenges which makes some of their services vulnerable.

To complete the consultation document, a detailed read of the 70 page Reconfiguration Framework Document published in July 2024 is necessary.

Readers then choose their response to questions from five options ranging from strongly agree, to strongly disagree.

This is just the start of a long process.

But the department says that to have your opinion noted and to make a difference the majority needs to take part.

What hospitals will offer what services?

Area hospitals: Belfast Hospitals Campus, Craigavon Area Hospital, Antrim Area Hospital, Ulster Hospital in Dundonald, Altnagelvin Hospital in Derry.

Local hospitals: Ards, Bangor, Dalriada in Ballycastle, Downe in Downpatrick, Lagan Valley in Lisburn, Lurgan, Mid-Ulster in Magherafelt, Moyle, Omagh, Robinson in Ballymoney, South Tyrone in Dungannon, Waterside in Derry, Whiteabbey.

General hospitals: Swah, Daisy Hill, Causeway

Regional centres: Royal Victoria Hospital in Belfast, Royal Jubilee Maternity Hospital in Belfast, Royal Belfast Hospital for Sick Children, Musgrave Park Hospital in Belfast, Belfast City Hospital including the Cancer Centre; Altnagelvin North West Cancer Centre in Derry.