Dr. Tom Black believes Mike Nesbitt did 'difficult job' well after shock resignation and replacement by Robbie Butler

Mr. Nesbitt resigned as Health Minister on Tuesday claiming he only learned the closure of emergency general surgery at the Causeway Hospital was a ‘red line’ for UUP leader Jon Burrows via the media.

Dr. Black, of Abbey Medical, said Mr. Nesbitt had been faced with the unenviable task of making ‘hard decisions’ and often having to ‘choose the least worst option’.

“When you have a service that’s underfunded and understaffed you need a minister who is prepared to make decisions based on the facts and that was what he was trying to do. He was trying to do the job on principle keeping politics out of the equation. In the end of the day it was local politics that undermined his position and caused him to resign,” Dr. Black told the ‘Journal’.

In a remarkable signing-off Mr. Nesbitt wrote to his party leader: “This letter concerns the fact you appear to have introduced a second ‘red line’, regarding Emergency General Surgency at Causeway Hospital. I am not the sort of Minister who is happy to discover the leader's view of issues under my purview by having to monitor the media.”

Mr. Nesbitt claimed the intervention created ‘shock waves’ in the HSC. Mr. Burrows who replaced Mr. Nesbitt as UUP leader in January thanked him for his service within the ‘toughest portfolio in government’.

In his letter of resignation Mr. Nesbitt claimed that when Mr. Burrows became party leader in January he had informed him that he had ‘but one "red line", namely puberty blockers and your opposition to Northern Ireland participating in the Pathways trial’.

"I accepted that, even though our engagement with Pathways was the price of securing the Executive's agreement to join GB's ban on blockers, something most observers thought impossible to achieve. Many Executive colleagues will rightly feel betrayed by my U-turn,” he wrote.

Mr. Nesbitt said the introduction of a ‘second red’ line by way of the media had made his position untenable.

But Mr. Burrows said: “Clinical evidence must be central to decision-making, but reform cannot simply be done to communities. There must be genuine engagement with the clinicians and staff delivering services and with the people who depend on them. I don't believe we have got that balance right, and the strength of feeling around Causeway shows what happens when communities feel decisions are arriving rather than being made with them.”

On Thursday Mr. Burrows nominated Lagan Valley MLA Robbie Butler as Health Minister. The ex-firefighter said he was under ‘no illusions about the scale of the challenge’ at Stormont’s largest and most expensive department.

"I intend to spend as much time as possible seeing health and social care at the front line, not from behind a desk. That was an important part of Mike Nesbitt's approach too, and I intend to build on the momentum he created while bringing my own ideas, energy and priorities to the role,” he said.

Mr. Burrows said: “The role of Health Minister is bigger than any one individual or party. At moments when the Executive has faced its most demanding challenges, this party has stepped forward, and we do so again today.”