The Urology Services Inquiry has concluded that systemic failures within the Southern Health and Social Care Trust led to patients being seriously harmed, with some dying because of delays in diagnosis and treatment. The inquiry, chaired by Christine Smith KC, examined care provided by consultant urologist Aidan O'Brien at Craigavon Area Hospital between January 2019 and June 2020.

The report found that concerns about O'Brien's clinical and administrative practices were known for years but were not adequately addressed. These included lengthy triage delays, missing patient records, and notes stored at his home. A confidential trust review uncovered more than 700 unreviewed GP referral letters in his office in 2016, including 30 red-flag cases, four of which later resulted in prostate cancer diagnoses.

Evidence presented to the inquiry also indicated that O'Brien prioritized private patients over NHS patients. A fellow urologist described how fee-paying patients were moved ahead of those on waiting lists. The inquiry chair stated that O'Brien was a skilled surgeon who did not intend harm, but the trust failed to recognize and manage him as a doctor in difficulty.

Health Minister Mike Nesbitt offered an unconditional apology for the failures, describing them as monumental. He said that patient safety must become the top priority across the health service and announced a Quality and Safety Summit to agree coordinated actions in response to the report's findings and previous inquiry reports.

The Southern Trust's medical director, Dr Stephen Austin, also apologized and accepted the inquiry's findings in full. He said a working group had been established to implement the recommendations without delay and that improvements had been made since the issues came to light.

The inquiry set out three core recommendations: making patient safety the primary objective, strengthening leadership, and improving the use of data to identify and respond to risks. The report stressed that systemic weaknesses in governance, oversight, and culture allowed the harm to occur and persist.

The inquiry was announced in November 2020 by then Health Minister Robin Swann after a series of serious adverse incidents involving O'Brien. It sat between 2022 and 2024, hearing from 75 witnesses and reviewing 650,000 pages of evidence. The findings are the second public inquiry report into Northern Ireland health services published within a week.