Maternity services at South West Acute Hospital are facing a recruitment crisis in the coming weeks, that if not solved could see the withdrawal of services. 
This scenario could mean women in Fermanagh travelling to Altnagelvin, and other hospitals to have their babies delivered. 
The Impartial Reporter understands that a failure to appoint trainee doctors to SWAH is central to the problem. 
The placement of trainee doctors is carried out by the Northern Ireland Medical and Dental Training Agency (NIMDTA). On its  own website NIMDTA state that: 
“NIMDTA seeks to serve the government, public and patients of Northern Ireland by listening to local needs and having the agility to respond to regional requirements.”
However, one trainee doctor who has worked across several Trusts, and speaking anonymously to this paper, explained, in his opinion: 
“The bigger units will be protected first and the rationale for that decision is that if you are going to keep the service across the Trust running at its optimum then you want the bigger units running at 100 per cent rather than all units struggling. So, the bigger units will be filled first with trainee doctors.”
They also explained that the trainee does not have the final say where they are placed in any six-month rotation:
“On a six-monthly basis we rotate. So, every six months I have the opportunity to ask for a certain job, but I don’t have the opportunity to pick a job and I definitely don’t have the opportunity to turn down a job.”
According to reports there has been a short fall for a number of years in the in the placing of trainee doctors to the Obstetrics and Gynaecology Department in SWAH with the result that there has been an over reliance on international doctors to fill the void. 
The Impartial Reporter asked the following questions to the Western Health and Social Care Trust:
1 - We have been told that maternity services at South West Acute Hospital are at risk of closing. Is this true?
2 - Can you also outline the allocation of personnel from the Northern Ireland Medical and Dental Training Agency (NIMBDTA) to obstetrics at SWAH for 2018/19?
3 - What is the historic allocation in recent years to SWAH from NIMDTA compared to other hospitals in the region?
4 - We believe there is an imminent threat to maternity services at SWAH. Can the Trust provide clarity on this?
5- What is the Trust’s message to the very many expectant mothers in rural Fermanagh, such as in the border of village of Garrison, who may not be able to give birth in Enniskillen because of this development? Where do they go instead? 
6 - Will, for instance, an expectant mother still be having her baby at SWAH in August?
In response to those questions the Western Health and Social Care Trust stated that it “has been experiencing some recruitment and retention challenges with medical staff in maternity services at the South West Acute Hospital” 
It is understand that these recruitment challenges are due to reach their most critical point in two weeks time and there are real fears that loss of services could result in patient safety being compromised. 
The Trust, however, deny that closure is imminent:
“The Western Trust is not planning to make any changes to the maternity services at the South West Acute Hospital…we are doing everything possible to ensure the services continue in a safe and sustainable manner.” 
The Impartial Reporter understands, however, that the failure to appoint trainee doctors, the over reliance on international doctors along with a high turn over of doctors leaving to take up training positions in other UK hospitals has led to a perfect storm of recruitment issues. 
In the last round of trainee appointments, it is believed that only one trainee was placed in Obstetrics and Gynaecology in SWAH. This, according to the trainee doctor who spoke to this paper, is part of an overall policy which is in place.
They continued by saying that there is little understanding of what is the reality on the ground in Fermanagh:
“People making decisions really don’t get the distance issue when it comes to Fermanagh. 
They look at everything in terms of numbers.  Garrison or Belleek to Altnagelvin can be two and a half hours, the roads are shocking. It would actually make more sense to go to Craigavon. Neither would be ideal. But people simply don’t take the rural nature of Fermanagh into consideration at all when decisions are being made.”