Mike Nesbitt’s sudden resignation this week ultimately came down to the fate of just one of the many hospitals under his remit – Causeway in Coleraine.
In recent years, it has been the move to consolidate maternity services at Antrim Area Hospital and a plan to do the same for Emergency General Surgery that has provoked anger among an energised campaign group and most local representatives.
The Northern Trust say it is essential to maintain services, but the final decision rests with the health minister, who ever that may be.
Meanwhile, the same dynamic has been playing out for years at Enniskillen’s South West Acute hospital, where EGS has been moved over 50 miles away to Altnagelvin in Derry.
Campaigners have made clear they will never be convinced it is the right decision and the majority of MLAs wanting to return to Stormont next year aren’t going to say otherwise.
Jon Burrows’ typically provocative style saw him declare at last week’s townhall meeting in Coleraine that he will fight to keep EGS in Coleraine, leaving Mike Nesbitt blindsided and unwilling to stay.
UUP leader Jon Burrows holds a press conference in the Great Hall at Parliament Buildings, Stormont, regarding the resignation of Health Minister Mike Nesbitt. PICTURE: JONATHAN PORTER/PRESSEYE
(Jonathan Porter / Press Eye)
The Alliance Party’s Kellie Armstrong called this a cynical and populist stunt that was damaging to the health service, while the SOS Causeway campaign group now fully expect the incoming health minister to act on their demands.
Streamlining hospital services had been a key part of Mr Nesbitt’s efforts in office, asking patients to travel further to where expertise and resources can be concentrated.
His Reset Plan also seeks to shift more hospital services into community settings.
The SOS Causeway group have long campaigned against changes to moving maternity and emergency general services away from Coleraine’s Causeway Hospital.
The question now is whether that momentum will shift towards the vote winning, but not necessarily life saving, option of preserving a broader range of services in sites like Coleraine, SWAH and the Downe Hospital in Downpatrick.
A more detailed response from Jon Burrows on Wednesday morning said that while clinical evidence was crucial, “reform cannot simply be done to communities”.
“There must be genuine engagement with the clinicians and staff delivering services and with the people who depend on them,” he said.
“I don’t believe we have got that balance right, and the strength of feeling around Causeway shows what happens when communities feel decisions are arriving rather than being made with them.”
Dr Alan Stout (BMA/PA)
Dr Alan Stout is chair of the BMA’s Northern Ireland council and said hospital reform was too often presented as an attack on rural communities.
“This obviously came to a head over EGS at Causeway Hospital, but in the greater scheme of the entire health service it is a relatively small part of the bigger and more rapid transformation that we need,” he told The Irish News.
“Everybody, without fail, agrees on the need for change but we’re stuck on that.
“This is worrying that even a relatively small change is creating a crisis with the resignation of the health minister.”
The uncertainty of having a caretaker minister until next year’s Assembly election, he added, was concerning.
“We have winter coming, pay disputes, the threat of industrial action and some important legislation that is supposed to be going through the Assembly like the Adult Protection and the Safe working Bills.
“It’s a real kind of tipping point as to what happens next.”
UUP leader Jon Burrows has criticised how health service reform is being implemented in Northern Ireland after his own party’s minister for the sector quit amid a row with him.
Health minister Mike Nesbitt resigned on Tuesday after a fallout with Mr Burrows over the proposed… pic.twitter.com/Rf7cnLSvKc
— The Irish News (@irish_news) August 19, 2026
With regards to Emergency General Surgery, he said it was clear across the UK and the wider western world that it is better to separate elective (planned) and emergency general surgery.
“You need dedicated centres with lots of expertise, big teams, access to diagnostics, access to recovery and rotas.”
Asked about the entrenched pattern of MLAs unwilling to change local services, he said: “I do have a degree of the sympathy with the campaign groups and local politicians, I think to break the cycle we need a much better articulation of the plans.
“It’s not about losing things and services, what we need is for the transformation of health services to be multi-factorial.
“That means you bolster a lot of services whilst potentially taking parts away to make them better.
“That’s what people don’t see, they only see things being taken away in a crisis environment.
“I think in fairness to a lot of people who campaign against it, the problem is that it hasn’t been explained well enough.”
The Causeway Hospital in Coleraine. PICTURE: MARGARET MCLAUGHLIN (MARGARET MCLAUGHLIN COPYRIGHT / )