This is a guest post by Hugh McCloy

Hugh has been a health & family law lobbyist since 2007 involved in groups including Save The Mid, RFFJ and, for a time, F4J. Hugh stood as an Assembly candidate in 2010 for Mid Ulster

The views expressed by Hugh do not necessarily reflect those of LAD

With recent performances in the Royal Hospital’s A&E being described as a crisis, what is the appropriate term to describe the even worse performing Antrim Area A&E?

Is the Royal A&E a manufactured crisis to mask the 4 year old problem in Antrim Area Hospital and Emergency Care across Northern Ireland?

Deaths In Antrim Hospital have doubled over a 10 year period yet the Health Minister stays quiet on Antrim A&E

Lost in the media and political storm over the crisis at the Royal other A&Es across Northern Ireland where performance is worse are being omitted from what should be a full investigation into the state of emergency care in Northern Ireland.


The crisis in Emergency Care in Northern Ireland began in 2009 when the Northern Health & Social Care Trust under the full knowledge of politicians began to wind down Mid Ulster A&E without preparing Antrim Area Hospital to be able to cater for the extra patients. The new A&E at Antrim while welcome is meaningless as in-patients capacity at the hospital has decreased. What is the point of building a A&E at Antrim that can allegedly deal with 90,000 patients a year if it’s in-patients can still only deal with 30,000 under escalated conditions.

Since 2010 the performance of Antrim has been worse than that of the Royal Victoria yet due to the age old antagonism in Northern Ireland that nothing major happens outside of Belfast the crisis at Antrim has been allowed to fester for 4 years at the cost of patient safety and patients lives.
What has changed in Antrim through the years?

Antrim A&E has been the subject of several reviews and consultations

In 2000 under the leadership of Sinn Fein Health Minister Barbrie De Bruin, a review carried out by Maurice Hayes stated that the maternity, A&E and acute in-patients be removed from Mid Ulster Hospital. This review was based on phase 2 of Antrim Hospital being built, the ambulance services being extended and a new road system, - none of these happened in the way intended. This review later became known as Developing Better Services.

Developing Better Services was such an important aspect to the future of health services in Northern Ireland that is sat on the shelf gathering dust until it was used to justify the closure of Omagh A&E in 2005 and it was used to prevent any legal recourse on the decision. It was later used to beat the Judicial Review against the closure of Mid Ulster A&E.

In 2006 Deloitte Touché carried out a risk assessment of closing Mid Ulster A&E as per developing better services, it scored highest in risk to patients and services to be shutting the Mid without improvements at Antrim as phase 2 had still not been built to provide more in-patients.

Despite this warning by the risk assessment the A&E at Mid Ulster was downgraded, ambulances were diverted from it and maternity was closed. Building phase 2 of Antrim was still nowhere in sight.

In 2008 the review of services though Michael McGimpsey's Comprehensive Spending review stated initially that no services changes were to take place at the Mid Ulster Hospital until 2013 and only then when phase 2 had been built at Antrim. This had changed by September 2009 when under the direction of the Health Minster & Health Managers the Northern Trust were directed to close acute services at both Mid Ulster & Whiteabbey in May 2010. 2010 also saw Tribal Consultancy recruited to review Antrim area hospital – the review had little effect on performance as it continued to slump.

The reviews also mislead the public with the risks to Mid Ulster that were in the consultation document being fabricated as proven in letter to the Northern Trusts Medical Director and CEO at this time. It was very apparent according to performance reports that late 2009 was when Antrim first showed the warning signs that it was not coping yet still no phase 2 build for Antrim was being planned and the trust went ahead and removed Mid Ulster A&E.

2011: still struggling at Antrim with bed capacity at a maximum. Wards 2 and 3 are shut at the Mid Ulster shortly after the Assembly elections and at the start of the summer recess, so no opposition could be launched to this. 2011 saw Edwin Poots announced as Health Minister and 'Transforming Your Care' begins.

2012: Mary Hinds & Dr Rutter carry out another review of Antrim A&E, still failing to fix the issues in the hospital much like the review 2 years before. Mary Hinds excludes that mangers bullied staff and later was appointed the CEO.

It was at this time plans were revealed that would turn the Mid Ulster Hospital site into offices and small clinics. There was even the option put on the table to rent out space in the hospital to charities and businesses. These plans were backed by Magherafelt Council, the only council in Northern Ireland who did not respond to Transforming Your Care. Instead of responding to Transforming Your Care they held a special meeting with the Northern Trust to agree these plans outside of the consultation process. Why the public were not made aware of this will never be known as people were responding to the consultation based on information that was in the public arena. When there was a public meeting to discuss some of the issues involved I was offered meetings with Sean Donaghy CEO of the Northern Trust to try and prevent me going to the public meeting and stating the truth to those in attendance. However I did take the invitation to meet Sean but I also made the public meeting which confirmed the attempted cover-up by the Trust, Patient Client Council and Magherafelt Council.

This led to a media battle between Magherafelt Council and me yet they could never bring themselves to have a meeting in private or public as they know they had been caught out
2013: saw the opening of the new A&E in Antrim Hospital, this went a small way to helping relieve pressures on the site but came nowhere close to solving the problem. When this was highlighted in the public arena by the former Chair of the Northern Trust Jim Stewart it was not long before Edwin Poots sacked him. Mary Hinds is appointed CEO of the Northern Trust despite her past failures in her review and an English Turnaround team was sent in and they remain to this day. The Turnaround team was headed by Sue Page from Cumbria Health Trust; this health trust was also the subject to malpractice and was reviewed by the Quality Care Commission.

2014: almost a year after the plans for Transforming Your Care have been finalised very little movement has taken place. Antrim Hospital is still the worst performing A&E in Northern Ireland and to help with changes to the A&E services among others another private consultancy business Ernst & Young have been brought in to aid Trust managers.

When you look objectively at what is happening in the Trust there has been reviews of services at Antrim Hospital for over 14 years, up until the Mid Ulster was closed each one of them stated that Antrim would not cope as only phase one was built. In this period the amount of patient deaths in the hospital has doubled and this is touted to be the safer outcome for patients that reviews since 2008 have bragged about. Also the cost of the reviews are not cheap but there always seems to be money for pointless reviews that state the obvious yet none for actual services.

Edwin Poots admitted on Hansard it was a mistake to shut the Mid Ulster Hospital; why so long after this admission has he not taken one step to reopen Mid Ulster and finally take the pressure of Antrim and make a difference to patients’ lives in the Mid Ulster Area?

At the moment he is hiding behind the crisis at the Royal and is happy to as he knows the crisis at the Royal is one he can walk away from with some level of integrity, and conveniently the crisis at the Royal diverts political and media away from the real crisis at Antrim Area Hospital.

What is the political stance across the board and how effective an opposition have any of the main political parties been to solving the health crisis over the years? Why are they blaming Transforming Your care when Transforming Your Care has not even kicked in yet?
  • DUP - they hold the ministerial position of health and will at all costs defend what is happening, responsible for closing City A&E, more in-patient wards and will if Transforming Your Care is implement completely remove statutory care homes and provision for elderly and children across Northern Ireland
  • Sinn Fein - are paying lip service to the crisis as they know the majority of the crisis we see today comes from the time they held the Health Ministerial Position and created the document developing Better Services that was used to shut Omagh, Mid Ulster and Whiteabbey A&E’s. It is the same document that stated that Lagan Valley should only have a local hospital while also saying that the Downshire area did not need acute hospital at all. To rub salt in the wounds Maurice Hays was a major contributor to Developing Better Services is now the man Sinn Fein are standing shoulder to shoulder with over the downgrading of the Downe Hospital.
  • SDLP – whose opposition amounts to writing a letter with their current stance being that of blaming Transforming Your Care? Let’s not forget that Transforming Your Care has not even been implemented yet Fearghal.
  • UUP – Held the Health Ministerial post and used Sinn Fein’s Developing Better services as a scapegoat to not take any responsibility for shutting health services during the Comprehensive Spending Review of 2008. But the PR machine of the UUP was no match to that of Sinn Fein’s.

Who is going to fix our health system ?????