Debate contribution: South West Acute Hospital: Future of Services

Debate contribution by Mrs Diane Dodds on 9 September 2025.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

9 September 2025

Type

Debate contribution

Business

Adjournment

Heading

South West Acute Hospital: Future of Services

Assembly identifier

Official Report component 5086825

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. I echo your words and welcome everyone from Fermanagh today. It is a long way up the road, but we will discuss a lot of long journeys as we go through the debate and try to make some progress. At the outset of the debate, I just want to say that my colleague Deborah is extremely disappointed that she is unable to be here. She is a passionate advocate for Fermanagh and South Tyrone and the South West Acute Hospital. I am sure that we wish her all the best at this difficult time.

I spoke to Deborah today. She wanted me to put on record her thanks for the way in which she has been treated. She is very grateful for all the work of the local community midwife right through to the hospital consultants. It just shows that while, sometimes in the House — the Minister will smile when I say this — we focus on the things that are wrong, really need to be fixed or are urgent, there are everyday people doing tremendous work in our hospitals. Emergency general surgery at the SWAH is not just a local issue; it is a regional one. It is an issue that has deep significance for how we transform our services and the basis on which we proceed. For families in Fermanagh, the South West Acute Hospital is not just another hospital option; it is the only acute hospital that is accessible within a reasonable time frame. Anyone who knows the geography of that most westerly part of Northern Ireland knows that travel time from somewhere like Rosslea to Altnagelvin Area Hospital is almost two hours. For people in Fermanagh, distances are long, roads are challenging and alternatives are not as feasible as they are for people in urban areas. That is the stark reality of rural healthcare. As if that were not enough, the Western Trust is proposing a permanent hospital service change based on the premise that the current arrangements at Altnagelvin are suitable and coping well. They are not. On 28 August 2025, the Royal College of Emergency Medicine released figures for emergency waiting times that show that patients in the emergency department (ED) at Altnagelvin wait between 19 hours and 89 hours. That is four days before admission to a hospital bed. At this stage, we should acknowledge that Altnagelvin hospital is also under huge pressure. Minister, you often talk about health inequalities, and rightly so. I hope that we are not insisting on creating another health inequality for rural communities in Fermanagh and, indeed, the general population of the west of Northern Ireland. Rurality needs to be taken into account in the design of services and, indeed, the transformation of our services. It is a fact that we desperately need transformation of health services in Northern Ireland, but, in this case, we are trying to transform services on the back of collapse and a lack of consultation with local people. Indeed, concern about the consultation on emergency general surgery (EGS) at the SWAH has been expressed not just by local communities and political representatives but by the Patient and Client Council, which was set up to represent and express the needs of patients in local areas. The temporary removal of emergency general surgery from the SWAH in December 2022 was brought about by an unplanned collapse in services. Many, myself included, argue that that situation was compounded by the fact that, in June 2022, the former Health Minister, Robin Swann, had published the review of general surgery in Northern Ireland, which established standards that hospitals must meet to continue to provide elective and emergency general surgery. SWAH could not meet those standards and therefore could not recruit, which led to a further crisis in staffing at the hospital. The Western Trust is completing a consultation on the closure of emergency general surgery at the SWAH. At the same time as that process has been going on, the Department of Health and you, Minister, have been consulting on a hospital network plan. That consultation was launched in October 2024 — I looked at the date today; I think that it was 1 October 2024 — but we have yet to hear the outcome of the process. Are you, Minister, still pressing ahead with the hospital network plan to change the SWAH into a general hospital? Eleven months after the publication of the plan, we still have no clear indication of the services that will be under SWAH's roof in future or of what your plan is likely to look like. In the middle of all that, Minister, you intervened via the local newspaper, which I have huge respect for — my father-in-law used to write copious letters to it every week; you are laughing, but it is true — to ask for a sustainability plan for the SWAH. There was no communication with elected representatives, despite the fact that Deborah Erskine and others were in direct communication with you before that intervention. Many viewed it as positive, but people in Fermanagh rightly want to know how these three processes — the consultation on emergency general surgery, the hospital network plan and the sustainability plan — correlate and work together. Which will come first: a decision on emergency general surgery or the reconfiguration decision? Minister, so many people have travelled from Fermanagh today, and others are listening to the debate. I hope that you have the answers that the community in Fermanagh so keenly await. They deserve to know what health services will be provided for them in that part of Northern Ireland. I will quickly look at another key report on the removal of emergency general surgery at the SWAH. The Regulation and Quality Improvement Authority (RQIA) report expressed concern about ambulance waiting times — patients triaged at the SWAH may need to be blue-lighted to Altnagelvin or elsewhere — and about the use of private ambulances, which are not regulated. Double ED waits, for patients waiting in Enniskillen and then facing another wait at Altnagelvin, were also identified as a problem. I outlined the extent of those waits earlier in my contribution. I asked the people who put together the RQIA report, "If we are looking at doing something about emergency general surgery at the SWAH and taking that to Altnagelvin, why were these processes not ironed out before this was decided?". Today, we need to know whether the processes have been improved. We need to know why it has taken so long to identify them. Is the system now more efficient? The Western Trust officials who briefed the Health Committee would like to tell us that it is, but many of the testimonies from those who have experienced the trust's services do not indicate that that is the case. Those are really important issues that our community in Fermanagh deserves to know about. Many people from the local Fermanagh community have joined together to express concern about healthcare provision in the area. I have heard my colleague Deborah Erskine talk many times about issues with Community Pharmacy and accessing GPs and the difficulties that there are in bringing everything together. Save Our Acute Services (SOAS) is a local campaign group that has produced a road map that could be considered for the SWAH. Minister, we are keen to know whether any of the recommendations in that road map will be considered. Members of the local business community have also expressed their concern. They are local employers, who point out that the provision of services is key to attracting the right workforce and to achieving a regionally balanced economy. That is something that we very often talk about in the Chamber. They are calling for a proper conversation to be had on healthcare provision in Fermanagh. Minister, we are all concerned about waiting times, but the reality is that two brand-new operating theatres for the SWAH have never been commissioned. Will the SWAH now receive fair funding from the elective care framework and be able to take its rightful place in the drive to increase elective surgery and to drive down waiting times? All five theatres and 312 beds should be used in the mission to eliminate the scandalous waiting times in Northern Ireland. That matters to all of us. This is an important debate for constituents in Fermanagh, but it is also an important one for all of us in Northern Ireland. The number of consultations that we have ongoing, the interventions that we have made and the clear lack of a process that a community can follow or even feel involved in point almost to a dysfunction in how we operate services for people in Northern Ireland. The South West Acute Hospital is a fabulous facility. It is delivering vital healthcare to one of the most rural populations in Northern Ireland, and there should be a proper process for, and a proper level of, access to healthcare for all in Fermanagh. That includes sustaining services and outlining what they should be for the hospital, and those services should include emergency general surgery. Minister, you have an opportunity to clarify the situation today. There are many people listening to the debate and waiting to hear about the way forward. I hope that you will take cognisance of rural populations in order to deliver appropriate services that are appropriately staffed. Safe, sustainable services are not an outrageous demand. They are something that our population — in this case, rural communities — deserves and should have.

1,596 words. Text as published by the Northern Ireland Assembly.

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