by Sabrina Sweeney
Simmering concerns in March over the proposed location of a new surgical hub to serve the north west have now boiled over into a full-blown crisis for healthcare in Donegal.
It’s understood a decision has been made regionally by the HSE to locate the day-case and planned surgery services at Sligo University Hospital and in an unprecedented move, 171 doctors from across Donegal have united to voice their opposition to any decision that overlooks Letterkenny, sending a joint letter to Minister for Health Jennifer Carroll MacNeill.
It’s rare for doctors to speak out so publicly, but their anger over the threat of this potential move has pushed them to do something significant; a collective action by medical professionals that underscores the gravity of the situation.
Their warning is stark: choosing Sligo over Letterkenny could be the beginning of a slow, quiet downgrading of LUH. A move that may mirror changes seen in the north of Ireland, where the removal of surgical services in certain areas has led to the erosion of wider hospital capabilities, including emergency departments.
While this might not be the stated intention, if you were to ask anyone in Tyrone or Fermanagh about the relocation of services from hospitals, they would tell you it rarely stops at one department.
Speaking from personal experience, having reported on the decision to remove acute surgery and A&E services from the Tyrone County Hospital in 2005 while working as a journalist at the Impartial Reporter in Enniskillen, plans for Letterkenny have many of the hallmarks of decisions taken by the Northern Ireland Health Minister back then, which ultimately led to the downgrading of the hospital.
If anything similar were to happen in LUH, the consequences would be catastrophic for Donegal, where the hospital’s A&E department is already under intense pressure and is a critical lifeline for thousands.
What makes this proposal all the more frustrating is that LUH is not a small or underperforming hospital, a charge levelled at the Tyrone County Hospital, 20 years ago, and other hospitals since then.
It is a busy, fully-fledged university teaching hospital that serves a vast geographical area and a growing population of over 160,000 people.
In fact, it regularly punches above its weight in terms of patient throughput, medical education, and staffing and yet, far too often, patients from Donegal are being sent to Galway, Sligo or even Dublin for procedures that should, in a fair and well-resourced system, be delivered at LUH.
The clinical expertise already exists in Letterkenny; the infrastructure, though stretched, exists. What’s lacking is the investment and recognition to allow the hospital to realise its full potential. Instead of being overlooked, Letterkenny should be supported to expand.
This decision feels like yet another blow to a region already battling the disadvantages of rural living. Donegal people are used to long drives, whether to routine appointments or for specialist services, but asking people to travel even further for what should be routine surgical care is not just inconvenient, it’s unjust.
A surgical hub in Sligo means round trips of up to five hours for many Donegal patients. There is no other region in Ireland facing this kind of distance for access to such care.
For older people, those without access to a car, or anyone managing multiple appointments, the burden is significant and it’s hard not to see it as blatant inequality; as rural people being told, yet again, to accept second best.
It’s important to say that this is not about rivalry with Sligo. No one wants to see any regional hospital lose out. But this decision is about proportionality and need. Donegal is the largest county in Ulster.
The government has repeatedly claimed that the new surgical hubs are about reducing waiting lists and improving accessibility.
So far, six hubs have been announced: in Cork, Dublin (north and south), Galway, Limerick and Waterford. The original plan, notably, included no hub at all for the north west. This underscores long-standing concerns about regional inequality in healthcare access.
And while every other part of the country will have a facility within reasonable reach when Sligo is added, only Donegal is being asked to go without.
Does the government expect people in Donegal to be grateful they don’t have to travel even further than Sligo? To just accept second best? The doctors who’ve contributed to the letter calling on the Minister to look again at this proposal don’t think so. And they deserve our full support.
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