Debate contribution: South West Acute Hospital, Enniskillen

Debate contribution by Mr Mike Nesbitt on 24 February 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

24 February 2026

Type

Debate contribution (made as a minister)

Business

Adjournment

Heading

South West Acute Hospital, Enniskillen

Assembly identifier

Official Report component 5404895

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. I thank Jemma Dolan for securing the Adjournment debate. I will always embrace an opportunity to talk about the SWAH. It is a gem. It is a wonderful facility: a great building and very modern. However, I go back to my normal formula: in order to deliver health and social care, you need the buildings, the beds, the equipment and the medicines. However, those four things are nothing if you do not have a fifth thing — the workforce — right.

The workforce at the SWAH is magnificent. I was down there recently, as Diana Armstrong said, and got the same message that I got from Daisy Hill Hospital when I was last there: "Never mind praising us for what we are doing, give us the ability to do more". There is a great appetite amongst the workforce in the SWAH to do more, and I want to facilitate that if I can. Let me be clear on this point: as far as I am concerned, the SWAH has a long and secure future ahead of it. I understand why much of the discussion has been about the temporary suspension of emergency general surgery, which has been in place, as we have remarked, since November 2022. I would prefer it if we had a little bit of balance there and perhaps talked up a lot of the stuff that the SWAH does, rather than the one service that it does not do at present. The SWAH supports a wide range of planned care activity, diagnostics, outpatient services and day-case procedures. It operates a busy emergency department, ensuring that patients can access care closer to home, where it is safe and appropriate to do so. You also have those two theatres that were not commissioned. Well, one has been commissioned. The independent sector is now delivering hips and knees, and over 70% of the patients who go in for a hip or knee replacement leave the same day. When Diana and I were down, we saw a man on crutches being taken along the corridors by the physio. He was just out of surgery. In fact, the reason that a lot of the 30% of patients who stay overnight do so is that they do not go through that procedure until mid- or late afternoon, so it is not safe to send them home. The SWAH is a wonderful, wonderful hospital doing wonderful things, so I do not really get why there is a narrative that, slowly but surely, services are being stripped away and the hospital is being downgraded. That is simply not the case. Yes, the temporary suspension of EGS has caused huge concern, but let us focus on what it does do. It is 14 years old and it has never been busier. It has never been busier or more active than it is today delivering surgical procedures. Record numbers from across Fermanagh and Tyrone, and sometimes further afield, are treated in the SWAH. On the issue of cross-border working more generally, the idea of North/South collaboration in health and social care is not new: we are already doing it. You know that I stand here as a unionist MLA with no political or ideological objection to cross-border cooperation in healthcare. In fact, quite the opposite, because, when you look at the border through the lens of health and social care, the last thing that it defines is "difference". People have the same needs and the same challenges in the border counties, whether they are northern or southern counties. I heard Jemma Dolan discuss North/South progress in healthcare, contextualised within her desire for a new Ireland, which means constitutional change. That is her right, but, as the Minister of Health, I will not bring party politics into my role. In border regions, perhaps in particular, North/South collaboration makes absolute sense. We should look for opportunities to work together, but it is not just border areas, and Danny Donnelly referenced the fact that, when you get to things such as rare diseases and some clinical trials, the population of Northern Ireland is not big enough. In fact, for some clinical trials, the population of the Republic of Ireland is not big enough, so an all-island approach, to bring in seven million people, is the only way to do it. That is another example of where cross-border cooperation makes absolute sense. There are a number of positive examples of cross-border cooperation in the Western Trust. For example, it has established mutual aid arrangements between the Northern Ireland Ambulance Service and the National Ambulance Service in Ireland. That allows for cross-border support in emergency situations. Ambulance crews regularly cross the border while undertaking routine transfer journeys and when responding to respective emergency calls. At the most-recent North/South Ministerial Council sectoral meeting on health, Jennifer Carroll MacNeill and I tasked officials to go away and look at areas where qualifications are asymmetrical — in other words, where somebody delivering health and social care here cannot work on the other side of the border, and vice versa. For the next sectoral meeting, we want a list of all the qualifications that are not in tune, and we will then figure out a work programme to try to address that. On the Western Trust and cross-border cooperation, there is participation in services delivered through the Cooperation and Working Together (CAWT) partnership, and I was delighted to go down to the Mellon Country Inn not that long ago to celebrate some of the EU PEACE PLUS money coming in. There is also access to all-island clinical networks in specialised areas of care such as congenital heart disease services and the cancer services in the North West Cancer Centre at Altnagelvin Area Hospital. In my time, I have had the honour of seeing first-hand examples of collaboration and how those benefit people here and across the border in the most profound way. They show that cross-border solutions can and do work, where there is a clear service need and clinical support and where appropriate governance arrangements are in place. Of course, as we have seen on various occasions before, whilst cross-border working may appear to be straightforward in principle, the reality is often much more difficult. We have a range of practical considerations to work through, and I have mentioned the ones that Jennifer and I have agreed on. None of it is insurmountable, but it requires detailed engagement with clinicians, regulators, commissioners, system partners and stakeholders on both sides of the border. However, I give you a commitment that, after the debate, I will expect a further assurance from officials that the Department and the Western Trust are fully maximising the cross-border potential of the SWAH for the communities that it serves. I also give you a commitment on a frustration that I share. In July, I asked the trust to pause the public consultation because I did not think that it was good. There was no consultation event in Omagh, and that was a mistake. The consultation event in Enniskillen was not on a good date; from memory, it was on 13 July. I am glad that the trust paused and then cancelled that consultation. I want the trust to produce the vision document, and it has had a significant number of months to do so. We cannot wait forever, because it should be the foundational document going forward. Áine asked whether I had requested that the Western Health and Social Care Trust develop a fully costed business case for the establishment of a new EGS service at the South West Acute Hospital. That is wrong way round: it is up to the trust to decide what services it is going to provide. If the trust comes to me with a fully costed plan to reintroduce emergency general surgery, I will look at it within the time frames and procedures that we have. You have reversed the process. I will be honest with you: it is not possible to reinstate EGS in the SWAH in the interim. We do not have the additional funding to do that at the moment. The reason for the temporary suspension must be read into the record again: the SWAH did not meet the standards identified through the review of general surgery, and it would require "fundamental change" in a number of areas to do so. The temporary suspension came into place because of safety issues. The trust experienced issues in securing sufficient substantive consultant general surgeons to reliably sustain an out-of-hours rota for emergency general surgery in the SWAH. There was no interventional radiology, and other issues were at play. Bringing in the temporary suspension was the right thing to do for patient safety. It is now up to the Western Trust to bring forward a plan — if that is its desire — to reinstate EGS, but, before that, the trust must give us its vision for the future of the SWAH, which is a wonderful hospital with a great future.

1,509 words. Text as published by the Northern Ireland Assembly.

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