Published Monday, 19 November 2012
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Until recently Dr Russell McLaughlin had been clinical director at the Royal's A&E, where just over 7,000 patients were treated last month alone.
But he has now resigned this post and there is speculation he has done so because he is unhappy with the way the department is being run.
A number of other consultants have also written to the Trust worried about how they are going to cope with the winter pressures.
Dr McLaughlin declined to be interviewed by UTV to clarify his position.
Meanwhile the Belfast Trust's medical director insists the A&E is safe.
Dr Tony Stevens said: "My understand in talking to him is that he has support for the management position although the work has gone on over the summer and since last winter to get ready for this winter.
We all have what I think is respect and concern for what is coming this winter
Dr Tony Stevens
"But he is anxious about this coming winter and it would be wrong to say that he isn't, when clearly other consultants have talked to the media and has expressed some concerns."
Asked if Dr McLaughlin had stepped down because he is unhappy with the way A&E is being run, or concerned patients are being put at risk, the medical director said no.
"I don't believe that patients are necessarily being put at risk we have made huge improvements in the way we run are service," said Dr Tony Stevens.
Chairman of the Health Committee, Sue Ramsey, said she has been raising the ongoing concerns about A&E at the Royal for the past few months.
She said when someone as senior as the clinical director steps aside there are problems that haven't been dealt with.
"People need to listen if the consultants and the staff are raising theses issues," said the Sinn Féin politician.
"People need to listen and they need to deal with the issue and I'm interested to know what the Minster is going to do about this."
There has been a 30% rise in the number of people attending the Royal's A&E since the emergency room at the City closed last year.
The medical director said it's coping and it's better off.
He continued: "There is two emergency departments, at the moment we are if anything better off because we are not having to stretch our resource over three emergency departments."
In a statement, Health Minister Edwin Poots said he is monitoring the situation closely insisted the number of people who have had to wait more than 12 hours at A&E has been reduced from 201 in March to three in October.
With winter fast approaching and the added pressures that brings to the Health Service, the Trust is says it's working hard on a plan to ensure it can cope.