By Sam Kessler
After losing maternity services last year, emergency general surgery is next on the chopping block at Causeway. The Northern Trust’s proposal from late 2024 would see emergency surgery no longer split between Coleraine and Antrim Hospital but centralised at Antrim.
The Department of Health (DoH) has not yet announced its final decision regarding the Coleraine hospital. In January, the suspension of emergency surgery at South West Acute Hospital (SWAH) in Enniskillen was announced, with no word on when services would resume. This follows the same approach as at Daisy Hill in Newry, which first saw emergency surgery suspended in 2023, before the service got the axe in January 2024.
There has been no indication from the DoH or Health Minister Mike Nesbitt (UUP) that things will be any different at Causeway.
Dire conditions
While the Northern Trust is correct in its assessment that Causeway Hospital is suffering from understaffing, this is not an issue that is isolated to the Causeway but rather hospitals all across the North, including Antrim Hospital. The reason for this is the conscious underfunding of the NHS by successive governments in Westminster and Stormont and this must urgently be addressed. Tellingly, while they speak of centralisation, there are no plans to increase staffing and overall capacity.
A survey by the Royal College of Nurses (RCN) has shown that 83% of nursing staff in Northern Ireland say the actual number of nursing staff on their last shift was “not sufficient to meet patients’ needs safely”. Almost two-thirds (60%) of nursing staff said they were unable to take the breaks they were supposed to during their last shift. All of this leads to a high sickness absence rate that is largely attributable to stress and mental ill health. All of this is having a dire and accumulative effect on nurses.
What is urgently needed is real action to tackling the waiting list crisis, which must mean proper funding and support for staff, and full funding of services. Numerous NHS Trusts have warned that the £135 million Mike Nesbitt proposed in the latest budget would actually mean health service cuts equivalent to the loss of 10,000 staff.
Rural communities
The Health Minister’s recent comments that “the vast majority of people are prepared to travel if it means going to get an area of specialism” show just how out of touch he is with the issues and the wider underlying problems affecting the NHS. Simply centralising crucial emergency services to one hospital is not a viable answer especially if, as here, it is not accompanied with investment in service, staff training and retention to ensure the necessary additional capacity.
Causeway, SWAH and Daisy Hill are providing crucial services to rural communities. Removing these services leaves vulnerable people further isolated and dependent on an ambulance service that is already stretched beyond its limit and inadequate public transport, especially in rural areas. This has huge implications for people being able to make appointments and visit loved ones while they are in hospital. Aspects that actually must be factored in also in the interest of maximising positive health outcomes.
Essential campaigns
All austerity cuts to our NHS need to be met with fierce opposition lest our health services continue to be picked apart. It’s already been left in a crippled state due to decades of privatisation and austerity cuts, made worse by the Covid pandemic. The state of the NHS is not an accident but the result of conscious decisions by politicians here and in Westminster to run down and underfund this vital service.
Various strikes of health workers in recent years have shown that we can and must fight. Decent pay and conditions are essential for staff retention and in the interest of both staff and patients. Unions must continue and step up their campaigning. They should also link with other campaign groups, fighting to save crucial and lifesaving services at SWAH and Daisy Hill and for a health service that is functioning and accessible to all.
