Nesbitt out
Following the resignation of two-time Ulster Unionist Party (UUP) leader Mike Nesbitt MLA from his ministerial position in August 2026 over a dispute with party leader Jon Burrows MLA over the Causeway Hospital, Robbie Butler MLA has become the new Health Minister.
On 18 August 2026, Mike Nesbitt MLA, who has served as Northern Ireland’s Health Minister since May 2024, announced his resignation from the role after what he calls UUP leader Jon Burrow’s introduction of a second “red line” regarding emergency general surgency (EGS) at Causeway Hospital.
In his resignation letter, Nesbitt said that when he became party leader in January 2026, Burrows informed him that he had one “red line”, referring to puberty blockers and his opposition to Northern Ireland participating in the Pathways trial of these.
However, Nesbitt said the UUP leader had effectively introduced a new “red line” over the hospital after Burrows indicated he would not support the removal of EGS.
In May 2025, following a review and public consultation, the Northern Health Trust recommend removing EGS from Causeway Hospital and instead providing at just one of its hospital sites, Antrim.
The Department of Health was still awaiting Nesbitt’s final recommendation as to whether this should occur at the time of his resignation.
At a town hall meeting regarding the issue in August 2026, which Nesbitt was unable to attend, Burrows went in his place and outlined his opposition to the removal of EGS from Causeway Hospital, saying: “Emergency surgery must remain at the Causeway Hospital and it should be built up, not run down and that is my position and it is not for negotiation.”
This prompted Nesbitt to resign as Health Minister, saying in his resignation letter that he was unhappy to have to “discover the leader’s view of issues under my purview by having to monitoring the media”.
The former Health Minister also said he offered Burrows “a way to manage this situation”, the day before his resignation but did not receive a “timely response” to this.
Nesbitt, who had already announced in January 2026 that this would be his last term in the Assembly remains a member of the UUP, and it is unclear whether he plans to resign from the party.
His decision to quit his role means that Nesbitt is the second former leader of the UUP to resign from their party or position over disagreement with Burrows, after Doug Beattie’s resignation in June 2026.
In a statement reacting to the resignation, Burrows thanked Nesbitt for his time as Minister, saying he had “arguably the hardest job in government and approached it with seriousness, integrity, and a determination to improve our health service”.
However, Burrows also criticised the former Health Minister for his approach to the Causeway Hospital, saying: “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 do not believe we have got that balance right.”
Nesbitt’s tenure
In his resignation letter, Nesbitt said: “Being Minister of Health remains the greatest privilege of my political career.”
Nesbitt was in the post for shortly over two years, taking over from another former UUP leader, Robin Swann MP, and he leaves behind a mixed record as Health Minister.
One of his biggest successes was in reducing waiting lists, overseeing a 14 per cent reduction in patients waiting more than four years for an outpatient appointment and a 21 per cent reduction in patients waiting more than four years for surgery.
His tenure also saw the publication of the 10-year Social Care Workforce Strategy, which outlined plans to tackle recruitment and retention problems in the sector.
However, record waiting lists in Northern Ireland remain with April 2026 seeing the worst 4 hour- and 12-hour performance for emergency departments in Northern Ireland for any quarter on record.
Additionally, figures from September 2025 showed that 55 per cent of patients were waiting over a year to see a consultant and no health trust had met its target for patients to be seen in under nine weeks.
Following his resignation, First Minister Michelle O’Neill MLA said she was “genuinely sorry” to see Nesbitt resign, adding that: “He played a constructive and mature part in the Executive and was making welcome progress in reducing waiting lists.”
New Health Minister
Former UUP deputy leader Robbie Butler, who served as an MLA since 2016, was selected as the new Health Minister by Burrows in August 2026. Butler is viewed as a leadership rival of Burrows and is reportedly in greater favour among UUP MLAs than Burrows.
The decision over Causeway Hospital is an immediate issue for the new Health Minister, although he has immediately delayed this decision, instead announcing another review.
In September 2026, Butler announced the creation of an independent expert advisory committee which will review how services will be delivered across hospitals.
The Reconfiguration Committee will advise the Minister on major or controversial proposals for permanent changes to health and social care services, such as the removal of EGS from Causeway Hospital.
Speaking after being announced as Health Minister, Butler said: “I take on this role with no illusions about the scale of the challenge. Too many people are waiting too long for care, too many staff are working under relentless pressure, and too many parts of our system are struggling to meet the needs being placed upon them.
“Those problems will not be solved overnight, and I will not insult people by pretending otherwise. But neither will I accept that they are inevitable.”
