As health bosses press ahead with the largest shake-up of the NHS, the future of some of Northern Ireland's biggest hospitals have been thrown into doubt.
Last month, the Health & Social Care Board approved a draft plan which will dramatically change the way healthcare is delivered here.
The vision includes cutting the current number of 10 acute hospitals by up to half, reducing spending on wages by £40m, which equates to 2,000 jobs, closing local hospitals, treating more patients outside Northern Ireland and slashing the number of care home places for the elderly.
The proposals are currently under consideration by the Health Minister, Edwin Poots, who will decide whether he approves of the way the changes are being made.
Once the proposals have been agreed it will be up to the health trusts to declare how they will achieve the aims of the commissioning plan.
Changes to emergency care provision at Lagan Valley and Belfast City hospitals are the beginning of a radical overhaul of services in Northern Ireland.
Mr Poots has already said the A&E at the Royal Victoria Hospital is secure and while he said there are no current proposals to close the A&E at the Mater, its long-term future is not guaranteed.
Under Developing Better Services, the site is set to become a local hospital, meaning acute services - including emergency medicine - would be scaled back.
When pressed on the future of the Mater's A&E yesterday, he said: "I am not a prophet, nor am I a prophet's son, so I can't say what will happen in 10 years time."
With opening hours at the Lagan Valley A&E due to be cut, acute care in the South Eastern Trust will be provided at the Ulster Hospital.
The A&E there is the largest of its kind in Northern Ireland, seeing around 67,000 patients each year and admitting 13,800.
Major renovation work is being carried out including the construction of a state-of-the-art critical care building.
Major works are also to be carried out at Antrim Area Hospital's A&E to enhance its capability.
The Northern Health & Social Care Trust has frequently come under fire for long waiting times at its A&E, but the unit is due to be extended and modernised to help cater for the additional patients coming through the doors following the closure of the A&Es at Whiteabbey and Mid Ulster hospitals.
While its future is safe, the same cannot be said of the Causeway Hospital.
Publicly, health bosses have said the Causeway will remain an acute hospital but behind closed doors they admit its status is being reviewed.
Difficulties recruiting staff - which were alluded to by Mr Poots yesterday - could mean many services, including acute emergency medicine, are shifted to Antrim.
The Western Health & Social Care Trust is likely to retain both its acute hospitals.
Altnagelvin is one of Northern Ireland's five designated cancer units and the Health Minister recently confirmed a radiotherapy unit will be built there.
And a brand new purpose-built facility, which represents a £450m investment in acute healthcare delivery in the south west of the province, is due to open outside Enniskillen next June.
In the Southern Trust, many believe Craigavon Area Hospital will survive the cull of acute services but the same cannot be said for Daisy Hill Hospital in Newry.
Trust bosses have denied there are plans to downgrade the hospital but as it is in dire need of refurbishment this may prove its undoing.
Mr Poots also said yesterday that he wants to look at the possible introduction of an air ambulance service.
"We have been talking about a shortage of junior doctors for two years and warning it could affect services. From a pragmatic point of view if there aren't enough staff to keep an A&E open then I think the decision made, whilst difficult and unpalatable, may be correct."
Dr David Farren, chair of the British Medical Association's (NI) Junior Doctors committee