The childhood vaccination rate and the care of new mums and their babies is being put at risk through cost-cutting measures, it has been claimed.
Doctors have warned that the high vaccination rates in Northern Ireland for devastating conditions such as meningitis, diphtheria and whooping cough, cannot be maintained while health trusts cut the number of health visitors working in GP surgeries.
They have said that the most vulnerable people in society, including babies in deprived areas and victims of domestic abuse, are likely to suffer most as a result of ongoing changes.
Dr Michael McKenna, who works in a GP surgery in west Belfast where health inequalities are rife, said: "It is getting to the stage where I am going to be unable to carry out childhood vaccinations in my clinic.
"I used to have a health visitor who came in and gave me a hand with vaccinations but that was withdrawn about 18 months ago.
"During baby clinics, we meet mum, chat to her, check the baby, give the vaccinations. We had a vaccination rate of about 97% but that is down to 91%."
Dr Joe McEvoy from Bayview Medical Practice in Londonderry said the removal of health visitors from GP surgeries could make it harder to identify and help victims of domestic abuse.
"I am aware of cases where a patient has confided in the health visitor during the baby clinic that their partner is violent," Dr McEvoy explained.
"Of course, it is important that health visitors are out in the community but that just wouldn't have happened if the appointment with the health visitor had taken place in the home with the partner present.
"Having the health visitor in the GP surgery means we can liaise with one another, share expertise and concerns about patients more easily."
The British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) have both said patient care is suffering as a result of the removal of health visitors from GP practices.
Dr Tom Black (below), chair of the BMA (NI) GP committee, described it as a "cost-cutting exercise".
Prof Scott Brown, chair of the RCGP in Northern Ireland, said he expects the move will result in a fall in vaccination rates and for there to be more ill health unnecessarily suffered by children.
"In addition, the opportunities to diagnose postnatal depression or abusive family relationships, which are both priority areas for the Department of Health, will be reduced," he said.
"The lack of health visitors will damage the quality of healthcare."
A spokeswoman from the Department of Health, Social Services and Public Safety said an official review of health visiting has acknowledged the importance of the visitors working with GPs.
She said there has been no change in policy regarding the working arrangements between GPs and the health visiting service and any difficulties should be addressed by GPs and their local health trusts.
A spokeswoman from the Health & Social Care Board (HSCB) said: "If a GP practice is unable to provide a childhood vaccination service then the practice should contact HSCB for alternative arrangements to be made."