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A campaign group representing rural communities in County Fermanagh has announced plans to take their hospital advocacy efforts directly to Stormont, expressing frustration that their concerns are being overlooked. The focus of their campaign is the suspension of emergency general surgery services at the South West Acute Hospital (SWAH), which has left some patients facing lengthy journeys to receive urgent care. Since the service was temporarily suspended in December 2022, patients from Fermanagh and Tyrone have had to travel approximately 90 minutes to Londonderry for emergency surgery.
In mid-2025, the Western Health and Social Care Trust’s board initiated a consultation on potentially making this suspension permanent, though this process has since been paused. The Department of Health (DoH) emphasized that any lasting alteration to emergency surgery provision at SWAH must receive formal approval from the department. Despite this, nearly 400 local residents gathered at a public meeting to voice their dissatisfaction, with the campaign group Save Our Acute Services (SOAS) declaring they feel both “abandoned” and misled by health officials.
Donal O’Cófaigh, a representative from SOAS, highlighted the length of time that has passed without access to essential emergency surgery at the hospital, describing it as “simply unacceptable.” Living close to the border in Belcoo, he noted the significant challenges posed by the long drive to Altnagelvin Hospital in Derry, the nearest center currently providing the service. O’Cófaigh also pointed out that reports are increasing of families affected by complications due to the lack of local emergency surgery, reinforcing the urgent need for the service to be reinstated. He stressed that the campaign has strong local backing and plans to bring their message to political leaders at Stormont.
The nature of emergency general surgery involves rapid response to life-threatening abdominal conditions and injuries, such as appendicitis, bowel obstructions, hernias, and gallstones. The Western Trust has stated that many patients can receive treatment at its ambulatory surgical unit without needing overnight admission, and that on average 2.5 patients are transferred daily to Derry for surgery. However, SOAS contests these numbers, arguing that the impact extends beyond immediate surgery to aftercare and recovery support.
Kate Clifford of the Rural Communities Network commented on the difficulties created by Fermanagh’s geography, pointing out the region’s poor road infrastructure and limited public transportation. Clifford described access to hospitals as “appalling,” especially when some patients must travel over 100 kilometers to reach emergency services. Eileen McGovern, another SOAS member, emphasized that the hospital’s emergency surgery service is both vital and a right for local people, criticizing the decision-makers who do not live in the area and urging restoration of services.
The campaign group has also initiated a legal challenge against the Western Trust following previous statements indicating that once a service is paused, it is unlikely to be restored. The Trust clarified that the remark referred to the inability to resume the service as it was before suspension in 2022, but noted improvements have been made at Altnagelvin Hospital, which now complies with current standards. Neil Guckian, chief executive of the Western Trust, explained that returning emergency surgery services to SWAH as previously provided would require substantial investment in infrastructure and specialized staff, including interventional radiology and renal services, as well as a dedicated bleeding rota. He reiterated that any permanent changes require Department of Health approval.
The Department of Health reiterated the importance of meeting evidence-based standards for emergency general surgery and confirmed that hospitals must adhere to official guidance when altering services. They stressed that SWAH remains a key hospital within Northern Ireland’s healthcare network and expressed commitment to its long-term sustainability and development. The department emphasized that permanent changes to the emergency surgery service at SWAH cannot be made without departmental consent
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