It is over a year since emergency general surgery was removed from our beloved South West Acute Hospital (SWAH). It happened just after Robin Swann ceased being Minister for Health. We were told it was a temporary cessation of this essential service.  

But how long is ‘temporary’? The community was assured that no other services would be affected or withdrawn from the SWAH.

They assured us that if emergency general surgery was required for any of the 84,000 people in the area covered by the SWAH, they would be adequately catered for in Altnagelvin or Craigavon, even though those two hospitals have great difficulty catering for emergencies in their respective areas already.

They cannot cope with patients from Fermanagh and the Omagh district. They are already struggling to cope with what they have.

For a whole year, some concerned citizens have worked day and night to have emergency general surgery restored to the SWAH.

I have attended well over 50 meetings in 2023, and I’m only a minor player.

I genuinely try to understand the Western Trust’s motives. I find it impossible to accept that responsible health planners would abandon the citizens who were well-served by the SWAH, and the Erne Hospital before that, without having a clear and viable alternative.

Every concerned citizen should make themselves aware of the consequences of what is being done to the SWAH.

This is no reflection whatsoever on the current SWAH staff, who are always superb.

But having a proper, functioning hospital is, literally, a matter of life and death for us and future generations.

We must do all in our power to have emergency general surgery restored as soon as possible for ourselves, our youth and our economic future. That’s the only solution. It’s what we had, and what we need now.

The Trust (and the Department) has given different excuses to different groups at different times, but their explanations never match the experiences of those of us who live and work here. The dots don’t join. We ask to be treated as adults; after all, our lives matter.

A further confusion is that officials from the Department of Health seem to have another set of excuses and plans for the future of the SWAH.

They seem to favour the SWAH being used for some vague plan for elective surgery. They argue that the presence of surgeons doing elective surgery will also provide cover for general surgery.

That is not a realistic long-term plan and, in effect, would mean the SWAH being used to tackle waiting lists for all of the North while providing little for this area.

It would at best be of minor benefit to locals. If there was a dedicated team of emergency general surgeons permanently assigned to the SWAH, then a programme for elective surgery would be a good thing.

Until last Thursday, we weren’t sure if our politicians were singing from the hymn sheet either.

The public meeting in the Westville Hotel eventually elicited a promise from the five main parties to work together for the restoration of acute services to the SWAH. That’s a start.

We will hold all five parties to that promise, and we will support them. The policy of divide and conquer is dead in the water. We will achieve our rightful services because ALL of us will work together.

During 2023, there was a so-called Consultation carried out in the name of the Trust. I attended two of these events.

I felt demeaned as a Fermanagh citizen; and more importantly, it was an insult to the people of our area.

The attitudes displayed showed an alarming arrogance as well as an ignorance of what this area deserves and needs.

SOAS (Save Our Acute Services) has done amazing work (as has a group within The Fermanagh Trust).

We all are determined to save our hospital. SOAS was able to gather more than 30,000 people to sign up in support of their five-point plan.

Yet, incredibly, those 30,000 signatures were deemed to be one miserly vote by those who organised the Consultation in 2023. What an insult!

There was a powerful rally on the Diamond in Enniskillen on November 12 which highlighted the disastrous effects of the absence of emergency general surgery in the SWAH, on a wide range of business interests.

The same narrative came from each of the five speakers.

The lack of proper services from the hospital is destroying the farming community, tourism, sports bodies and every single industry of note. Lives are put in danger.

Tune in to what those leaders said. They were brief, to the point and devastatingly honest. Yet these competent leaders are simply ignored.

For example, the President of the Ulster Farmers’ Union explained to the large gathering that farming is a high-risk occupation. Getting immediate medical attention when farm accidents happen is essential.

Waiting for an ambulance is precarious enough, but having to go to Derry, bypassing a superb, well-equipped hospital, on a road that is antiquated and dangerous, will undoubtedly lead to unnecessary deaths. It could be me, or it could be you.

Another frustrating problem is that it is impossible to get those in authority to accept responsibility for their decisions.

It is too convenient to blame the absence of a working Stormont for the blatant neglect of our people in this area. They say nothing can happen until Stormont is restored.

But the body that withdrew emergency surgery from the SWAH did so in the absence of Stormont, so why can’t they also restore it?

The Western Trust is responsible for Altnagevlin, Omagh and the SWAH. It was they who decided to ‘temporarily’ remove emergency surgery from the SWAH – apparently without even an adequate risk assessment of the consequences of their decision.

If that is true, it is a scandal beyond belief.

Ultimately, the Trust will be responsible for the consequences of leaving us without access to emergency general surgery and acute services. It is difficult to accept the ‘excuses’ we are drip-fed.

Ultimately, they must provide the services to the people in their care. We are not second-class citizens, and we should not allow ourselves to be treated as such by any responsible system.

The Western Trust and the Department of Health must provide us with a proper life-saving service; we have a right to that as a minimum.

The Constitution of the NHS begins: “The NHS belongs to the people. It is there to improve our health and well-being ...”

Further on when dealing with NHS values, it gives us this ideal: “Patients come first in everything we do.”

Note it is not Consultants who come first, but patients. Not the accountants, civil servants or administrators who come first. Their first duty is to ensure the best possible range of life-saving services for all patients.

The NHS Constitution puts it in plain English: “The patient has a right to ... receive care and treatment that is appropriate to you, meets your needs and reflects your preferences ... You have the right not to be discriminated against in the provision of NHS services ...”

Indeed, the NHS pledges “to make decisions in a clear and transparent way, so that patients and the public can understand how services are planned and delivered”.

The SWAH came into existence over a decade ago, after a forensic consultation process which concluded the most appropriate site, where the greatest number of people can have emergency care available to them within an hour (approximately), is where the SWAH stands today.

The geography of the area means that all of Fermanagh and the relevant parts of Tyrone need an Acute hospital in the Enniskillen area. That was the conclusion of the independent body. Their decision was challenged, and a Judicial Review was granted.

The Review stated clearly that this is the best site for the SWAH. Those who say the SWAH should never have been built are simply wrong.

Others declare that it is a done deal to run down the SWAH and hand it over to private health providers.

It is not a done deal, and we should fight that attitude tooth and nail. We in Fermanagh are a much-neglected community.

I hope our elected politicians realise soon how deprived we are and agree to do whatever it takes to bring investment and infrastructure here.

But how can we build our community if our prized hospital is denuded? The most basic piece of infrastructure in any developed area is access to essential health services.

SOAS is succeeding in keeping the struggle going. They have made gigantic strides in fighting our cause. Fermanagh Trust is in negotiations with relevant authorities too.

My plea is for all politicians, all the relevant groups and, in particular, the people of Fermanagh and Tyrone, to stand up and fight for this fundamental human right – namely, to restore emergency general surgery to the SWAH.

It is not a gift – it is a right. We cannot take no for an answer. I appeal to people, politicians and businesses to form an invincible alliance to ensure proper health care for our families and our communities.

We can settle for nothing less.