The Tyrone County Hospital treated victims of the Omagh bombing
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The Tyrone County Hospital in Omagh is to lose its emergency and major elective surgery services, the government has confirmed.
The decision follows six weeks of public consultation on the issue.
Health Minister Shaun Woodward also recommended strengthening A&E services at the Erne Hospital in Enniskillen.
A 24-hour doctor-led urgent care unit will be set up at Tyrone County, which will continue to receive patients brought in by ambulance.
Mr Woodward said the plans offered "the best way ahead for the immediate period and viable transition towards the long term".
"The hospital will continue to meet most of the in-patient medical care needs of the local population, including coronary care," he said.
"Only very seriously ill medical cases, in particular those likely to require intensive care services, would not come to Omagh."
Ambulance
Mr Woodward said the Omagh area would be getting an extra 24-hour ambulance to boost the existing service, along with another intermediate care ambulance.
The transfer from Omagh to Enniskillen of emergency and major elective surgery services will take place early next year.
Accident and emergency services will also be consolidated at the Erne over the coming year.
The government's plans for Tyrone County had faced sustained opposition from politicians and campaigners in the area.
Dr Kieran Deeny, an independent assembly member elected on the single issue of the Tyrone County's future, gave the plans a cautious welcome.
He said he was glad the Omagh hospital would still be able to stabilise people prior to transferring them somewhere else.
"As regards the needs of the south west in the long term, this is not the answer," he said.
"(But) it will certainly help us in the short term as doctors and nurses on the front line responsible for saving lives."
Hospital campaigner Danny McSorley said he was disappointed by Monday's announcement.
"We feel (the minister's statement) failed to meet the needs of the people of Tyrone for safe and accessible accident and emergency services.
"We want an urgent meeting with the minister to clarify his statement because it is very unclear."
Mr McSorley said he wanted Mr Woodward to take notice of the views of thousands of people who protested in Omagh last month against downgrading of the hospital.
New hospitals
Mr Woodward had already announced two new hospitals would be built in the Sperrin and Lakeland Trust area, costing £270m.
He has said £95m would be spent in Omagh and building work would begin in 2007.
In Enniskillen, £175m would be spent on the new hospital which will be part of the network of wider acute services with Altnagelvin and Craigavon, a range of inpatient, critical care and A&E services.
In September, a report by the Royal College of Surgeons said hospital services in the south west were "unsafe and unsustainable".
The report said patients' lives were being put at risk at Tyrone County Hospital in Omagh.