Southern Health Trust plans community health hubs
Plans to move services from Daisy Hill Hospital out into the community have been described as putting the hospital's future at risk.
A document leaked to the BBC describes how the Southern Health Trust proposes creating up to seven treatment centres.
The local MLA Dominic Bradley said it was unnecessary and weakened the status of the hospital.
The trust said its proposals were about accessible, community-based care that supports people close to their homes.
The trust proposes to reduce the number of GP practices in the area by creating the new treatment centres instead, the BBC has learned.
The move would see many services being shifted out of the Newry hospital into the community.
To encourage GPs to move elsewhere, the trust may have to buy buildings or pay off current leases.
The trust said it wanted to create accessible, community-based care.
The document, leaked to the BBC, said in the Newry area for instance, seven GP practices are currently located in their own accommodation at Newry Health Village, one is located on separate premises at Monaghan Street in Newry and another at Forkhill.
"There would be a requirement for these premises to be bought out should GPs choose to move to a new community treatment and care centre," it said.
Mr Bradley, SDLP, said: "If they transfer a lot of these services such as cardiac and treatments for stroke and diabetes, there is less for the hospital to do. And in the future that only weakens its status."
At the moment, all of the health trusts are drawing up proposals as to how they will deliver health and social care services in the future.
Last year, the document, Transforming Your Care, was published by the chief executive of the Health and Social Care Board, John Compton.
It wants to relieve some of the pressure on hospital services by transferring them to the community instead. It is also cheaper for the health service to provide some services away from hospitals.
For the first time, the BBC can reveal how one health trust plans to do this.
A document entitled Review of Proposals for the Development of Primary and Community Care Infrastructure describes creating up to seven community treatment and care centres or "hubs".
These centres would provide services including minor surgery, out of hours facilities and treatments for cardiac, diabetes and stroke patients.
The seven areas to benefit are Portadown, Banbridge, Lurgan, Armagh, Newry and possibly Kilkeel.
Population plans are currently being drawn up by business consultants, Ernst and Young.
These will give specific breakdowns of people living in areas including the number, age group and gender of people living in towns and rural areas including their long term conditions.
It is on that basis that health trusts will argue the need for retaining particular hospital services.
While the Department of Health insists the contract is worth £661,000, the BBC understands the final bill could be closer to £900,000.
If their population figures do not support facilities, including maternity or emergency departments in a particular area, that information could be used by the health board and even the health minister to argue they should be closed.
The Health Committee is expected to challenge the contract when it meets senior representatives from the health department later.
The chair of the committee, Sue Ramsey said she would be asking why the board cannot do the job.
"That's a question for John Compton and that's a question I'll be asking him," she said.
"They need to inform us how they can justify spending that type of money when it goes back to the point that the Health and Social Care Board is there, it's there to commission services, they should know what the population plan is.
"They need to convince me, they need to convince the committee and they need to convince our constituents that this is money that they need to spend."
Mr Bradley told the BBC that while he supported change, nothing he has heard so far warrants such massive upheaval for GPs and patients.
"Why fix what isn't broken? We already have a hub - which is Daisy Hill Hospital. It's already providing all those services under one roof," he said
While the Southern Health Trust believes it can sustain its current hospital services, new safety standards due to be issued by the health board could mean it is forced to close the maternity or A&E departments in either the Causeway or Daisy Hill hospitals.
In a statement to the BBC, a spokesperson for the Southern Health Trust said: "The Southern Health and Social Care Trust has set out a long-term vision for the development and organisation of primary and community care services in the southern area.
"Our proposals are based on the creation of accessible, community-based care that provides support to people as close to home as possible.
"The community care and treatment centre concept, which is already working successfully in Portadown and which the minister has provided funding to develop in Banbridge, provides a base for a range of community services, working alongside GPs, to be brought together under one roof.
"This will support team working and patient centred care, and the development of a wider range of services in local areas.
"The development of these centres complements specialist acute hospital services, and is in line with the direction set out in 'Transforming Your Care' - providing community based services which will reduce the need for hospital care and will support people to remain at home."