It should not be a surprise that any restructuring of hospital services will generate concern about the impact on local communities.
Hundreds of people attended a public meeting organised by the Daisy Hill Emergency Surgery SOS group this week amid fears about a downgrading of the Newry hospital.
Stroke services were last week moved from Daisy Hill to Craigavon, with officials citing staffing issues.
Emergency general surgery has already been transferred and a shortage of consultants has put some inpatient specialities at risk.
Campaigners fear that any suspension of services will inevitably become permanent and aim to escalate protests and political engagement.
A similar scenario is being played out in Enniskillen, where fears have been expressed about services at South West Acute Hospital.
Emergency general surgery was temporarily suspended over recruitment issues last November, requiring patients to be transported to Altnagelvin in Derry and other sites.
Rallies have been held and petitions signed in an attempt to ensure the decision is reversed.
Meanwhile, in Coleraine, no more babies will be born at the Causeway Hospital following a decision to 'consolidate' maternity services at Antrim Area Hospital from next month.
Officials say that with birth rates falling and Causeway reliant on temporary staff, having all births take place at one dedicated site will provide a 'safe, more sustainable staffing model'.
The plans attracted a protest last month but Department of Health permanent secretary Peter May has argued that "avoiding planned change would simply lead to unplanned and forced change".
Similar arguments were made at the time of the Bengoa report seven years ago, which advocated a focus on 'systems, not structures' to ensure sustainability of services.
There is broad agreement that the health service requires a massive programme of both investment and reform to tackle shocking waiting lists and chronic staffing shortages.
There are undoubtedly also concerns about the ability of a smaller number of large hospitals to cope with increased demand as well as the road infrastructure to transfer patients over longer distances.
What is beyond doubt that a piecemeal approach, where change only comes about when services deteriorate to the point of collapse, is not in the interests of patients or staff.
Only the immediate restoration of a Stormont executive along with cross-party agreement to address the NHS crisis will prevent further protests spreading across the health service.
