Surgeons have warned that a prolonged delay in deciding the future of emergency general surgery at Causeway Hospital will place clinical teams under greater pressure, following the resignation of Health Minister Mike Nesbitt in a dispute over the service.

Mr Nesbitt resigned after UUP leader Jon Burrows stated at a meeting in Coleraine that he would not support the removal of emergency general surgery from the County Londonderry hospital. The Northern Health and Social Care Trust had proposed centralising the service at Antrim Area Hospital. Robbie Butler was subsequently appointed as the new health minister.

Three professional surgical bodies - the Association of Coloproctology of Great Britain and Ireland, the Association of Upper Gastrointestinal Surgeons, and the Association of Surgeons of Great Britain and Ireland - wrote to Mr Butler. Their letter stated that failure to modernise surgical services risked perpetuating workforce pressures, limiting access to care, and widening inequalities in patient outcomes. The associations said decisions on service configuration should be informed by clinical evidence, patient outcomes, workforce sustainability, and population needs.

Surgeon Damian McKay, who spoke on behalf of the associations, said the reform process had been under way for almost two decades and that the current model of providing emergency general surgery across two acute sites was unsustainable. He said the Northern Trust had been relying heavily on locums and cover was stretched across two sites, with a real risk of service collapse. He added that running too many emergency surgeries on too many sites also affected cancer waiting times.

The Northern Trust board approved a recommendation in May 2025 to centralise emergency general surgery at Antrim Area Hospital, while most planned general surgery would take place at Causeway. A GIRFT independent review in March 2026 found the status quo not sustainable and that consolidation on the Antrim site was clinically and operationally appropriate. However, the trust cannot implement the change without Department of Health approval.

TUV leader and North Antrim MP Jim Allister said less than two percent of respondents to the trust's consultation had supported the plans. He questioned whether Antrim Area Hospital could cope with the additional workload and accused consultants of talking down to people dependent on Causeway Hospital.

Department of Health interim Permanent Secretary Mike Farrar told Stormont's Health Committee that the process was not complete, no proposals had been put to ministers, and no decision had been taken. He said officials would not recommend the proposal unless the eventual business case demonstrated improved health outcomes. Officials also said there were no plans to close Causeway's emergency department and that the change related only to specialist emergency abdominal surgery.

Mr McKay said that if no decision was made before the end of the current Assembly mandate, he would be very concerned. He said implementing any change would require considerable planning, and that a vacuum would leave teams under significant strain.