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A former consultant at the Southern Health Trust has told Northern Ireland's inquiry into Urology services that provision has been inadequate.

The inquiry, established in 2021, is examining the trust's handling of urology services prior to May 2020.

The work of former consultant Aidan O'Brien is at the centre of the hearing.

In his first appearance before the Inquiry, he said the service was never properly established.

Now retired, Mr Aidan O'Brien held various senior roles for almost 28 years.

Previously the inquiry heard that more than 1,000 patients' records were recalled - with hundreds having received suboptimal care.

Aidan O'Brien said the service established in the early 1990s was "grossly inadequate from the start" and he had "struggled" with the board to get the recognition the service required.

When asked by Martin Wolfe KC, lead counsel to the inquiry, if there was a demand capacity mismatch from the start Mr O'Brien said "that is absolutely correct".

The inquiry heard that the inadequate provision of a urology service is not just a local issue but an international one where it fails to get the support and recognition required.

Mr O'Brien said when it comes to the number of dedicated medics and services, if Northern Ireland was a sovereign country it would be "at the bottom of the European League with the Republic of Ireland just above it".

He added that the then director of public health didn't think there was a need for such a service when the trust's population in the 1990s was more than 269,000. In the UK there was one urologist per 53,000.

Mr O'Brien told the inquiry a combination of factors including financial systemic issues and bias in recognising the importance of the service had all contributed to it not being unable to meet growing demand within the Southern Health Trust area.

Mr O'Brien also highlighted issues he faced when asking for extra resources from the chief executive at the trust, John Templeton.

"After a few years with the same items on your shopping list I came to the conclusion that repeatedly asking for these things was not only not productive but I felt it was actually counter-productive."

"You're left with a disillusionment and fatigue - don't waste time raising concerns and asking for more because it's a waste of time."

The inquiry was established in March 2021 by then-health minister Robin Swann to review the trust's handling of urology services prior to May 2020.

In his witness statement provided to the inquiry before it opened to the public, Mr O'Brien said he had faced a "relentless burden" in his job.

Urology is a part of health care that deals with diseases of the male and female urinary tract.