The boss at Belfast Health & Social Care Trust was heckled by protesters shouting "Shame!" as a controversial proposal to close one of Northern Ireland's busiest A&Es was given the green light.

Colm Donaghyleft moments after the decision to shut the casualty unit at Belfast City Hospital to catcalls from union members and hospital employees, yesterday morning.

Preparations are being finalised to shut the doors at the hospital's A&E, which deals with over 40,000 patients each year, before the beginning of November.

The mood throughout the meeting was tense with accusations of "monumental failure" by management made by those opposed to the closure.

Claims that lives will be lost as a result of axing the service at the City Hospital were met with counter claims by Mr Donaghy and other senior trust staff that the changes are necessary to protect patients.

Patrick Mulholland from public service union Nipsa said closing the A&E "will create havoc and cost lives".

However, Dr Russell McLaughlin - who heads up the trust's casualty units - said: "I speak as a doctor who sees it from the sharp end and having three A&Es isn't sustainable.

"As a senior doctor, we are rendered much less effective than we could be by being spread across three sites.

"It perpetuates the notion of consultants working nine to five which isn't the case.

"We are not going from a perfect system, we are going from a deeply flawed system right now.

"As for the additional distance people will have to travel, it is not of clinical relevance.

"If you are going to die between you becoming unwell and travelling an extra half mile down the road then you are going to die anyway."

Trust bosses have argued the changes are necessary as there are not enough consultants in emergency medicine in the trust to ensure adequate supervision of junior doctors.

At the meeting yesterday, Mr Donaghy said the closure is temporary and could be reversed if additional senior doctors are found.

However, union representatives said they believe the City Hospital casualty unit will never reopen.

Last month the Belfast Telegraph revealed the change at the City Hospital A&E will remain in place until the implementation of permanent changes to A&E services in Belfast - not expected for 12 months.

Mr Donaghy confirmed this was the case at yesterday's meeting.

Meanwhile, there are concerns the Ulster Hospital will struggle to cope following the closure of the City Hospital's A&E.

More people are now expected to turn up at the Dundonald hospital for emergency treatment and patients will also be taken there by ambulance if casualty units at the Royal Victoria and Mater hospitals reach their full capacity.

A spokeswoman from the South Eastern Trust said: "Emergency admissions to the Ulster have increased by 10% in the past year alone.

"It will be a huge challenge to provide increased capacity at short notice and staff are spending long hours working through the details of our plans."

Background

In July, the Stormont health committee was told by Health Minister Edwin Poots that A&E units in Belfast were likely to be cut from three to two, and said the City Hospital's unit was in the firing line. Mr Poots said the changes are necessary for patient safety because there are not enough senior doctors to supervise junior doctors working in Belfast's A&Es.