NHS crisis Northern Ireland: Concerns that Daisy Hill Hospital in Newry could be downgraded to such an extent that some of its core services could be run by doctors from other hospitals.
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On Thursday the Southern Health Trust announced that it was having to withdraw its acute stroke service from Daisy Hill and divert all patients to Craigavon Area Hospital from 31 May.
The trust cited a shortage of doctors, with reports that nine consultants have left in the past six months.
The trust closed its emergency general surgery services at the hospital in February, also citing the same problems, and is currently consulting on the future of that department.
Chief Executive Dr Maria O’Kane said this week that there is "great concern in meeting the demand for acute inpatient medicine and providing stable medical staffing cover in our medical wards".
The ongoing changes have fuelled renewed social media speculation on the future of the hospital.
Rachel Killen, UNISON Newry & Mourne Branch Secretary, told the News Letter: "If emergency general surgery is permanently lost from the hospital, it will be a massive threat to Daisy Hill which will impact on all the other services".
She welcomes Department of Health plans to make the hospital a centre for planned elective surgeries for patients from across NI. "But you are kind of getting one thing at the detriment of what you already have."
She laments that the new hub is unlikely to bring any new doctors to Daisy Hill, but rather borrow them on a day-to-basis from other hospitals. "That would probably be the plan, yes."
Dr Tom Black, British Medical Association NI Council chair, said that aside from locums, Daisy Hill now has only one consultant on their medical team who is full-time permanent.
"So the acute medical service is in a precarious position," he said.
He too agrees that the loss of the emergency surgery would undermine every other department. "There's some truth in that, yes."
And he agrees that an Elective Surgery Hub at Daisy Hill would be mainly staffed by doctors from other hospitals.
He believes the £1.1bn the Stormont parties are reportedly seeking to restore the Executive would "certainly stabilise the situation".
The Department of Health carried out a Review of General Surgery to address NI-wide shortages of doctors and long waiting lists.
In October, then Health Minister Robin Swann announced that Daisy Hill would become an Elective Overnight Stay Centre for patients with moderately complex cases.
As with the UNISON concerns, he affirmed that doctors operating the service in Newry would not be based at that hospital. "Surgeons and patients alike will travel to Daisy Hill from different parts of Northern Ireland," he said.
Meanwhile, the Stroke Association says the withdrawal of acute stroke services from Newry is extremely worrying.
Alasdair O’Hara, the charity’s associate director for NI, said: "Despite the Department of Health publishing an ambitious Action Plan last year to improve stroke care in Northern Ireland, we have yet to see any progress on transformation." A comprehensive and adequately resourced long-term plan to retain staff is needed, he added.
The Southern Health Trust responded that it has insufficient stroke consultants at Daisy Hill, so the decision has been taken on safety grounds to divert all acute patients to Craigavon Area Hospital from 31 May.
The same measure was taken in February, but services were later reinstated. "We are working with other Trusts in Northern Ireland and the Department of Health to help us through this situation,” it added.