McNulty MLA challenges The Southern Trust’s decision to temporarily suspend Maternity Services at Daisy Hill Hospital

Today, 3rd November, Justin McNulty MLA spoke at the Southern Health and Social Care Trust Board meeting where the board decided on the Proposal for an Emergency Temporary Service Change of the consolidation of Daisy Hill Hospital inpatient maternity services to Craigavon Area Hospital.

The magnitude of the decision was reflected in the number of elected representatives with speaking rights, and the number of people present in the audience, including a large representation from the SOS Daisy Hill Committee, who organised last week's rally.

Mr McNulty's speech was as follows:

"Good morning and thank you to the Board for granting me Speaking Rights today on the issue of Consolidation of Daisy Hill Hospital inpatient maternity services to Craigavon Area Hospital.

“I know you will all be aware of the incredible strength of feeling on this issue. Thousands of people gathered on Sunday 25th October at the SOS Save Daisy Hill rally, with expectant mothers and Daisy Hill staff leading the march. The rally was a profound outpouring of community strength and togetherness unified on the issue of maternity services at Daisy Hill. I want to pay tribute to the SOS Committee, many of whom are here, for the incredible work they have done.

“In speaking before you today, I firmly challenge the rationale and fairness behind the potential shift of maternity services at Daisy Hill Hospital to Craigavon. Of course, patient safety must be paramount. However, how will patient safety not be compromised for mothers in labour, who may be experiencing complications, being forced to drive an extra hour on bad roads to get to the hospital? Or the mothers whose babies arrive prematurely and urgently need medical attention?

“What happens when a woman presents to Daisy Hill Emergency Department in advanced labour, with an imminent birth or with a serious obstetric emergency? What immediate obstetric and midwifery support will be available?⁠ ⁠What arrangements will exist for emergency transfers to Craigavon? ⁠What happens if a woman is too unwell to transfer safely or there is an unavoidable delay?

“These are foreseeable clinical scenarios, not hypothetical possibilities. What assurance can the Board provide that comprehensive emergency pathways will be in place, adequately staffed and tested before implementation?

“Secondly, where is the patient safety for patients in the medical and surgical wards at Craigavon whose care will be impacted if Craigavon struggles to accommodate a doubling of the number of births they already had from this transfer? The proposed consolidation involves transferring all inpatient maternity activity from Daisy Hill to Craigavon. This represents a substantial additional workload.

“It is not simply a question of whether there are sufficient beds. The Trust must demonstrate that there is adequate capacity across the entire maternity service, including:⁠ ⁠Delivery-suite rooms and Inpatient beds;⁠ ⁠Midwifery staffing; ⁠Consultant obstetric cover; Anaesthetic cover; ⁠Emergency theatre capacity; ⁠Neonatal services and more.

“What modelling has been undertaken to demonstrate that Craigavon can safely absorb this additional activity, particularly during periods of peak demand and when managing simultaneous obstetric emergencies?

“How many additional staff, beds and delivery rooms will be provided? What happens if Craigavon reaches capacity?

“How will the Trust ensure that the existing Craigavon service is not compromised by absorbing the additional workload?

“The Trust has repeatedly described consolidation as the safest and most sustainable option. However, its own published FAQs indicate that several important assessments and operational arrangements remain in development.

“These include: ⁠Travel-time analysis; ⁠Equality screening and rural-needs assessments; Quality-impact assessments; ⁠Additional bed and delivery-suite capacity at Craigavon; ⁠Workforce requirements;Emergency pathways for women presenting at Daisy Hill.

“How can the Board make an informed decision about the safety and appropriateness of consolidation without having completed and scrutinised all relevant assessments?

“Will the Board receive the full clinical, operational, workforce, equality and rural-impact assessments before approving the proposal? Will these documents be made publicly available?

“It is important that the Board is not simply accepting assurances but has sight of the actual evidence supporting the decision.

“Additionally, what will happen to the 80 staff members at Daisy Hill who are going to be impacted by this move. I spoke with senior midwives who have consistently been banging this drum and warning about this issue for a long time coming. I have raised their concerns about maternity services at Daisy Hill, and those concerns have been dismissed.

“Temporary closure is a line we've heard before. The old tried and tested roadmap for service removal. If this closure is temporary, where is the clear, measurable or time-bound commitment to restoring inpatient maternity services at Daisy Hill? What does temporary actually mean? A general commitment to restoring services when staffing permits is not the same as a credible recovery plan with measurable objectives, accountability and timescales.

“This closure is the result of a workforce planning issue that advocates have been raising alarm bells on for years and has been ignored for too long. Given that the vulnerability of the obstetrics and gynaecology service has been recognised within the Department of Health's Support and Intervention Framework since November 2024:

“⁠What recruitment and retention initiatives have been implemented the past two years? What efforts have been made to explore regional or cross-border support? I have long said that Daisy Hill needs to be expanded to become a hub hospital serving its natural hinterland on a cross-border basis. Have alternative consultant staffing arrangements and cross-site working models been fully explored? What lessons have been learned from the workforce planning difficulties that have brought the service to this position?

“Importantly, consolidating services at Craigavon does not resolve the underlying shortage of consultant obstetricians. What assurance can the Board provide that the same vulnerabilities will not subsequently affect Craigavon?

“We need to see more serious efforts to recruit consultants and attract consultant obstetricians to the Southern Trust, to create the conditions to attract these vital workers. Suspending maternity services at Daisy Hill is not the answer.

“Finally, Maternity services do not operate in isolation. They are interconnected with obstetrics and gynaecology, anaesthetics, theatres, paediatrics, neonatal services and emergency care.

“Has the Trust undertaken a comprehensive assessment of the cumulative and longer-term impact of removing inpatient maternity services from Daisy Hill?

“What assurances can the Board provide that this will not lead to further erosion of services, difficulties with recruitment and retention, or undermine the long-term sustainability of Daisy Hill?

“It is not acceptable to scapegoat this Trust or the Minister or the Department of Health. It is unacceptable to me that the First Ministers, who have been very visible and vocal on other issues recently, have been silent about maternity services at Daisy Hill.

“Expectant mothers, families and staff affected deserve transparency and meaningful engagement, rather than simply being asked to accept assurances that consolidation is necessary."