Health campaigners ask for clarification about the South Eastern Trust’s decision to change night doctor arrangements
Following concerns discussed at a recent meeting of the Down Community Health Committee (DCHC) in Downpatrick September 2026), the chair of the DCHC wrote to the South Eastern HSC Trust Chief Executive Roisin Coulter.
The DCHC’s concerns centred around the reduction of doctor night cover at the Downe Hospital and the questions are numbered below.
“At our recent Down Community Health Committee meeting, there was some discussion concerning the reduction in doctor cover at night in the Downe.
Please provide us with the following:
1. A list of the consultees consulted in connection with this decision.
2. A note of the dates on which each of the consultees was consulted.
3. A copy of the evidence used as a basis for the decision.
4.Confirmation of the date on which a decision to review the level of cover commenced and at whose instigation it commenced.
5. A copy of the similar review documents for the Lagan Valley and Ulster Hospitals.
6. A copy of the rurality proofing and Equality Impact Assessments in connection with the proposal.
“Given the urgency of the matter, your earliest attention would be greatly appreciated.“
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In her reply, Roisin Coulter set out her response below.
“Please see below information from South Eastern Trust.
“The Trust remains fully committed to maintaining and strengthening medical services at Downe Hospital. Recent changes to the out-of-hours medical rota were introduced following concerns from training bodies and resident doctors that the previous arrangement provided a poor educational experience and risked the loss of trainee doctors from the site. This change is as a result of these issues raised since previous correspondence.
“In the Minister’s correspondence in May, he notes the need to continuously analyse and understand the best way to deliver services. A review of activity at Downe found that the historic requirement for two doctors overnight was no longer supported by service demand data, including admissions, cardiac arrests and inter-hospital transfers. The new model replaces the resident doctor with a more experienced doctor overnight, supported by an on-call consultant and senior nursing colleagues, trained in Immediate Life Support.
“Importantly, this change increases the availability of medical staff during daytime and evening hours, improves continuity of care on the wards and in outpatient services and enhances training opportunities for junior doctors. Additional investment has also been made in SAS and Clinical Fellow posts to strengthen the medical workforce.
“The changes have the support of the Consultant Team and are expected to provide better overall medical cover for Downe Hospital, not less. The redesign is focused on improving patient care, maintaining training accreditation and securing a sustainable medical workforce for the future.”
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Since the closure of the 24-7 A&E at the Downe Hospital on 4th April 2013, the calls for its re-opening from residents across East Down have been many like a running sore on the side of the South Eastern HSC Trust which appears adamant that an A&E is not necessary for the area.
The new Downe Hospital officially opened on 28th June 2009.
Weekend A&E services were subsequently withdrawn 5 years later from 4th January 2014.
An appointment-based Urgent Care Centre opened in its place on 19th October 2020.
Initially, the Trust argued that they could not find consultants to staff the A&E and this festered on for a number of years with the “temporary” closure becoming more “permanent”. An Urgent Care system and Out Of Hours GP systems evolved and many have questioned the effectiveness of these as certain protocols were applied and patients were funnelled off to the main hospitals in Belfast.
Considering that it could take at least 60 minutes to travel by car to the main hospitals in the Belfast area, even in an emergency, people in East Down feel isolated and treated as second-class citizens and genuinely fear for their lives.
The DCHC campaigners argue that the main aim of the Downe A&E should be to provide equitable health care, and not prioritising a training platform for junior doctors which should be regarded as a strategic outcome of having an A&E.
The DCHC and the South Eastern HSC Trust are poles apart in the discussion around re-establishing a Downe A&E.
The Minister and the South Eastern HSC Trust must therefore listen to all the stakeholders, including medical staff and the local population. Otherwise, the debate will continue.
The DCHC chair Eamonn McGrady indicated that he will refer the issue on up to the Permanent Secretary of Health for further clarification.
(Jim Masson / Down News©2026).
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