Recommendations

Nine acute hospitals New south west hospital Merge four boards into one Reduce hospital trusts to three Downgrade seven local hospitals Double hospital consultants 25% more GPs

It would be one of nine remaining hospitals offering emergency care in the province.

However, the report proposes the removal of accident and emergency services from five existing smaller acute hospitals.

It also recommends the rationalisation of hospital administration by replacing the four health boards with one "strategic commissioning authority" and merging the 18 hospitals trusts into three "integrated health systems".

'Money for people'

Speaking on BBC Radio Ulster, Dr Hayes said he did not want people to focus on the proposals for health service structures when considering the proposals.

Dr Maurice Hayes chaired the review

He said: "What we want is for money to be spent on people on nurses, doctors, physiotherapists, dieticians, and all those professions ancillary to medicine.

"We are trying to provide a seemless service where patients can move easily from primary care, easily through all the services they need."

Dr Hayes also called on people not to delay Department of Health decisions based on the report through opposition, because the public was "crying out for" decisive action.

"What we are trying to do is centralise the things that need to be centralised and decentralise everything else," he added.

"The status quo isn't an option. The service will collapse and good people will leave."

'Golden nine'

Before devolution, the Department of Health wanted to close seven of Northern Ireland's existing acute hospitals, centralising acute services to six main hospitals.

However, the report recommends that three more should be added to the original six.

The original six were the Royal Victoria and City Hospitals in Belfast, the Ulster Hospital outside Belfast, Antrim Area Hospital in County Antrim, Altnagelvin in County Londonderry and Craigavon in County Armagh.

The report says the Causeway Hospital in Coleraine, County Londonderry, Daisy Hill hospital in Newry, County Down, and a new Southwest hospital in Enniskillen, should also be acute centres.

'Downgrade local hospitals'

While the report proposes that five acute hospitals should have their acute service removed, it also recommends more treatment should be given closer to patients' homes, either in health centres or new local hospitals.

Hospitals which would lose accident and emergency services would be the Mater in Belfast, Omagh in County Tyrone, the Lagan Valley in Lisburn, County Antrim, and the Whiteabbey hospital in Newtownabbey, County Antrim.

The Downe and Downpatrick hospitals would lose their maternity services.

The recent closure of acute services at the South Tyrone hospital in Dungannon would also become permanent.

However, the report does not recommend closing any existing hospitals.

It is understood the hospitals would be grouped into three super trusts:

Southern including - Craigavon, Daisy Hill and the new southwest hospital.

The report recommends doubling the number of hospital consultants and increasing the number of GPs by 25%.

'Doctor rotation system'

It suggests a rotation system for doctors between the acute and local hospitals.

It also advocates more cross-border co-operation on health and investing in the ambulance service to help it improve response times.

It is understood that the proposed timescale for implementing the recommendations would be about 15 years, with a target date of 2008 for setting up the three new hospital trusts.

The findings of the report will go out for public consultation and it may be another six months before any decisions are made on the future of acute hospitals.