Sinn FΘin's Northern Health Minister, Ms Bairbre de Br·n, is facing a decision no politician would want to deal with - two constituencies, both represented by Sinn FΘin MPs, but only one acute hospital that both communities are desperately campaigning for.
One of the two Sinn FΘin MPs - Pat Doherty of West Tyrone and Michelle Gildernew of Fermanagh/South Tyrone - will have to see their constituents disappointed. Either Omagh or Enniskillen will get the acute hospital.
It will be one of the most difficult decisions Sinn FΘin in government will have to stand over. In the two constituencies, where the party gained seats in this year's Westminster elections, the issue is at the very top of the agenda.
The competition for the hospital is fierce. In both towns steering groups have been formed, led by the local district council, with representation from businesspeople, community and voluntary groups and medical professionals.
Ms Gildernew said the party chose the Health Ministry knowing it would be "a poisoned chalice". Faced with a choice between Health and Agriculture, they chose Health because they believed Sinn FΘin was the party most committed to providing services to the people who needed them, she said.
However Ms Gildernew also said that while Minister de Br·n was "overseeing the process", she would not be making the decision on her own as it would go to Executive of the Assembly.
The decision making process is set to be a very long one - the issue has been discussed for years. One deadline was reached at the end of October, with the closing date for responses to a report by Dr Maurice Hayes.
Dr Hayes chaired an Acute Hospitals Review Group which was set up last year by Ms de Br·n and its report was published in June. One of its recommendations was for a new acute hospital to be located in, or near, Enniskillen and for Omagh to get a new local hospital.
The Hayes report, along with responses to it, will now be considered by the Department of Health which will issue its own recommendation. There will then be a further period of consultation before the matter finally goes back to the Executive.
Ms Gildernew and others campaigning for Enniskillen are obviously pleased with the Hayes report. She said his conclusions were based on "common sense".
But Mr Danny McSorley, the chief executive of Omagh District Council and chairman of the Omagh steering group, is very critical of the methodology used by Dr Hayes.
The Omagh group commissioned consultants, the York Health Economics Consortium Ltd of the University of York to review the methodology and findings of the Hayes report.
Stressing that it was an independent review, it concluded the hospital should be located in Omagh.
Dr Hayes addressed the issue of how to maximise accessibility for the region's very dispersed population of 115,000 people.
He concluded: "Omagh would provide a slightly larger caseload, but would leave a larger number of people outside acceptable access times". A location in Enniskillen would provide cover for "a wider geographic albeit thinly populated area" and would ensure that people living west of Lough Erne were not disadvantaged, the report said.
Dr Hayes said he had considered if Sligo General Hospital could be used to complement a hospital in Omagh to meet the needs of the dispersed population west of Lower and Upper Lough Erne, but the condition of the road between Blacklion and Sligo meant travelling times would be in excess of an hour.
Mr McSorley said the Hayes report was "not an evidence based report". The report by York Health Economics Consortium Ltd said it pointed up "flaws, inconsistencies and omissions in the decision-making process" of Dr Hayes' review group.
The York report concluded that a hospital in Omagh would be more accessible for the majority of the population and that 60 per cent of the population would be within 30 minutes drive, whereas in Enniskillen only 47 per cent would be within 30 minutes drive.
It also stated that 12,000 people in the south east of Fermanagh and 1,400 in the south west of the county would look to emergency services in Cavan and Sligo, as these were the nearest hospitals.
"The facility would not exist in the long term because it does not have the catchment population," Mr McSorley said.
Ms Gildernew and others in Enniskillen argue that it would not make sense to locate the new hospital in Omagh because it would be too close to the existing acute hospital in Altnagelvin in Derry.
Mr McSorley said that this proved his point that in the long term if people around Omagh started to go to Derry instead of Enniskillen, the new hospital would not be sustainable because the population it served would be too low.
Dr Hayes only gave "lip service" to cross-Border options, he said.
Mr McSorley said their campaign was not about "Tyrone against Fermanagh" but it was about securing the highest quality service for both counties.
Ms Gildernew and other delegations and submissions from Fermanagh have tried to counter the arguments put forward by the Omagh steering group and the Sinn FΘin chairman of Omagh District Council, Mr Barry McElduff. He said he would stress that the decision should not be political but should be "evidence-based".
Ms de Br·n's recommendation is not expected for many months and a final decision may not be taken until the end of next year.