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Editorial: Health service reform cannot be delayed

THE decision to halt emergency surgery at Daisy Hill Hospital in Newry will inevitably spark fears about a downgrading of services at the site.

From the end of February, patients who require admission for surgery will be transferred instead to Craigavon Area Hospital.

The reason is not Covid pressures, which have had a huge impact on staffing across the health service, but difficulties recruiting surgeons.

Despite repeated attempts, only two out of six general surgical consultant posts at Daisy Hill have been filled - and one of those will soon become vacant.

The Southern health trust said this represented a “very immediate and major risk for the safety of our service”.

The transfer of patients to the larger Craigavon site has been described as an interim measure pending a full consultation on sustainable services in the area.

The trust has also insisted it remains committed to maintaining the busy accident and emergency department at Daisy Hill.

While the decision this week relates to particular pressures in Newry, it fits with a pattern of problems being experienced across the north's health service.

It has been obvious for many years that the system is unable to meet demand, with the length of waiting lists a source of shame for a developed country.

The Bengoa report published in 2016 - as well as similar studies before it - highlighted how many services are struggling to recruit and retain staff under the current configuration of hospital care.

Concentrating resources on specialist sites makes it easier to attract doctors by offering greater opportunities for professional development, promotion and research, as well as improving outcomes for patients.

The great difficulty has been securing the political will to ensure difficult decisions are taken.

The assembly collapsed before Bengoa's recommendations could be implemented, and five years on, with limited progress made, a threat again hangs over the devolved institutions.

The Covid crisis has not only highlighted how much we depend on our health service but exposed the cracks as outdated structures struggle to meet ever-increasing expectations.

Bengoa warned that the choice was either embracing planned change or resisting reform, allowing services to deteriorate to the point of collapse and change to come about by crisis.

That process of transformation may or may not result in emergency surgery being retained at Daisy Hill Hospital, but it is a process which must be accelerated.

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