Rural lives cannot be an 'afterthought', healthcare campaigners say
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Donal O'Cofaigh of Save Our Acute Services (SOAS) says people are "already losing their lives" due to a reduction in rural services Rural lives "cannot be an afterthought" when it comes to health transformation, campaigners have said.
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In a joint "letter of concern" to the Northern Ireland Executive, four hospital campaign groups have called for a cross-departmental working group on rural health access.
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The campaigners have warned that rural communities "face the real threat of being cut off from timely access" to acute and other vital hospital services.
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In a statement the Department of Health said "every decision across the health and social care system is taken on the basis of safety and delivery of the best outcomes for all citizens".
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It added: "Minister Butler is acutely aware of the issues faced by those living in rural areas and he takes those issues very seriously."
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Donal O'Cofaigh from Save Our Acute Services (SOAS), based in County Fermanagh, said it is "vital" that executive ministers collectively consider decisions about removing services from local hospitals.
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SoS Causeway Hospital group, Save Our Services Daisy Hill and the Down Community Health committee were the other three groups that signed the letter.
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No time for new minister to fix health service warns top doctor Removing emergency surgery will create 'domino effect', campaigners warn 'Lives will be lost' unless services are restored at hospital For several years the groups have been campaigning against the closure of acute services in their areas.
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In their letter, the campaigners said that past healthcare decisions have been framed as "purely operational or clinical, with too little cross-departmental scrutiny".
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After being temporarily suspended in February 2022, emergency general surgery (EGS) was permanently removed from Daisy Hill Hospital in Newry in 2024.
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Maternity services at the hospital could also be suspended from next month after the Southern Health and Social Care Trust said it was preparing for the "possible consolidation" of services to Craigavon Area Hospital from 23 November.
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In 2023, maternity services were permanently suspended at Causeway Hospital and consolidated at Antrim Area Hospital.
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EGS was temporarily withdrawn from South West Acute Hospital (Swah) in Enniskillen in 2022.
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In July 2025, the Western Health and Social Care Trust's board agreed to consult on the permanent removal of the service from the hospital, but the public consultation was later closed after the trust agreed to "pause and consider".
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The health trust said it is now working with stakeholders "to develop a clear vision" for healthcare in the area, with EGS remaining suspended at Swah while this takes place.
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Last year, the Northern Health Trust recommended providing EGS at just one of its hospital sites - meaning it's likely to be removed from Causeway Hospital.
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But the move cannot proceed without approval from Health Minister Robbie Butler, after his predecessor, Mike Nesbitt, resigned amid a party dispute over the proposal.
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Inpatient maternity services are likely to move from Daisy Hill Hospital in Newry to Craigavon Area Hospital next month O'Cofaigh said: "It's simply not good enough to allow services to temporarily [be removed] or collapse under pressures and then do nothing about it for years and just leave that as the situation."
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The groups called for a "presumption of restoration" - a pathway to restore services in cases where they were removed from rural hospitals without the appropriate assessments or scrutiny.
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"We cannot accept the situation where our communities are disadvantaged simply because of where they live," O'Cofaigh continued.
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"We are second-class citizens at the moment.
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Stormont is presiding over that system."
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The campaigners said communities are forced to travel "long, unsafe distances for emergency care when they are at their most vulnerable".
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O'Cofaigh said this was an "outrageous situation".
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"It has very significant impacts on people's lives," he added.
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"It's re-entrenching wider disadvantage." Members of the campaign group Save Our Acute Services (SOAS) pictured outside Stormont in February 2026 O'Cofaigh hopes Stormont ministers will recognise the "severity" of the situation.
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"If you have to travel long distances, waiting long times to receive life-saving, treatments...then the health outcomes are different.
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They're not the same.
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"The procedures can be much more complicated...
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People are already losing their lives.
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We're seeing it."
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The campaigners have also told the executive that rural-proofing is "non-existent", stating that "decisions have been repeatedly made without meaningful assessment of the differential impact on our communities".
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They have called for independent rural-needs and equality assessments, as well as a cross-departmental ministerial working group on rural health access. In September, Health Minister Robbie Butler said a new independent expert committee would provide him with advice on major or controversial proposals for permanent changes to health and social care services.
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He also asked officials to review the existing guidance governing the change or withdrawal of services, including consideration of rural and equality impacts.
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