August 25, 2026
Writing in the Coleraine Chronicle today, Eunice Minford, Consultant Surgeon & Clinical Director, Northern Trust
Over the past week, the debate around the Northern Trust’s proposals to transform its general surgery service at Causeway Hospital has dominated headlines, prompted intense political debate and generated understandable concern for our staff and local community.
As a consultant surgeon working within the Trust, I completely understand the strength of feeling around the proposed change at Causeway, and the fears people have around what that means for their care and the hospital’s future.
However, as surgeons we have a responsibility to raise concerns regarding the fragile condition of the current model and to take action to address those concerns to ensure safe, high-quality surgical care for the foreseeable future.
Put simply, the choice before us is not between change and no change. The choice is between a planned change we can control, or an unplanned change driven by a workforce crisis.
Every day, our surgical team cares for patients with a wide range of surgical conditions, including those that are serious and potentially life-threatening. To provide that care safely, we need experienced surgical teams available around the clock, every day of the year.
The challenge we face is that it is becoming increasingly difficult to maintain a consultant workforce that can safely provide emergency surgery across two separate hospital sites on a 24-hour, seven-day-a-week basis.
Across the health service, recruiting and retaining specialist staff has become increasingly difficult. These workforce pressures have affected hospitals throughout Northern Ireland and made it harder to maintain sustainable emergency surgical services across multiple sites.
This is why the consultant surgeons in the Northern Trust support the proposal to consolidate emergency general surgery at Antrim Area Hospital.
Some people have suggested that the alternative is simply to leave things as they are. From a clinical perspective, however, this is not a viable option.
No surgeon wants to see services become unsustainable. Equally, no surgeon wants to be in a situation where staffing shortages could threaten the quality or safety of care patients receive.
The proposed model our Trust has put forward for approval is the result of years of planning, workforce review, clinical engagement and service development.
The reform has been shaped by extensive engagement with clinicians and reflects the direction set out in the Bengoa Report, the Department of Health’s Review of General Surgery, and is supported by GIRFT – Getting It Right First Time, an NHS programme that helps hospitals improve patient care and make the best use of specialist expertise.
Together, these reports support the principle of concentrating the expertise needed to deliver high-quality patient care in the face of growing workforce challenges.
I want to stress that the current debate about emergency general surgery is not about the value of Causeway Hospital.
Causeway remains a highly valued and important acute hospital with a central role in delivering care to the local population. The Emergency Department will continue to receive and treat patients with urgent medical and surgical conditions, and patients suitable for ambulatory care will continue to be seen and assessed through the Causeway Surgical Ambulatory Unit.
There are plans to expand elective surgery and Causeway Hospital is an essential part of general surgery reform, which we cannot do without.
The future of Causeway Hospital is not in question. The issue is how we organise emergency surgical services in a way that is safe, stable and sustainable for years to come.
Many people understandably worry whenever services are changed. As someone who has dedicated my consultant career to caring for patients in this Trust, I genuinely appreciate those concerns. As surgeons we want to provide safe, high-quality care and as a team we believe the proposed changes are necessary to ensure we continue to do so for decades to come.
Our duty is, and always will be, to provide patients with the highest standard of care possible. Having seen first-hand the pressures facing emergency surgical services and the challenges of recruiting and retaining the workforce needed to maintain them, we believe these changes offer the best opportunity to safeguard general surgery services within the Northern Trust.
At a time when so much attention is focused on politics, we must not lose sight of what matters most and what should unite us all: ensuring that all patients continue to receive safe, high-quality emergency surgical care whenever they need it.