Health Minister Michael McGimpsey is today on a collision course with Ulster doctors after they warned his plans to stall Health Service changes would drive the province back to the "bad old days of 10 years ago".
The British Medical Association (BMA) has hit out at the minister over his " exceedingly alarming" decision to delay further changes to the Health Service set out as part of the Review of Public Administration (RPA).
Dr Brian Patterson, who led a BMA delegation which recently met with the minister at Stormont, said he feared stalling the matter would have serious consequences for NHS patients.
Mr McGimpsey sparked concern last week when he confirmed that any further RPA structure changes, designed to save cash by streamlining how the Health Service is run, would be unlikely before April 2009.
But RPA changes are already at an advanced stage with the new Health and Social Services Authority (HSSA) due to replace Northern Ireland's four health boards next April. The single authority's senior management, including its chief executive David Sissling, have been in place and on the payroll since last summer. The province's 18 health trusts have already merged into five.
Now it's unlikely the new HSSA will come into existence until at least April 2009 - if at all.
In an interview with the Belfast Telegraph, the minister said he was determined to examine all possibilities before making any decisions on the future. This may or may not include a single health authority, he said.
Dr Patterson, the BMA (NI) chairman, said: "We were exceedingly alarmed when we first learned of the minister's decision to delay the changes to the NHS.
"However, we are even more concerned because after our meeting we believe that another 18 months at least may well pass before much-needed reforms are put in place.
"We were very disappointed that the minister was unable to identify for us his specific problems with the RPA process, bearing in mind that this review received public consultation twice over the past few years. "
Dr Patterson said the delegation set out doctors' concerns to the minister.
"We told him that we believed the NHS here is already on its way back to the 'bad old days' of 10 years ago, when we disgracefully had the highest waiting lists in Europe," he added.
"We are about to lose the gains achieved by previous administrations and that is indefensible.
"We advised Minister McGimpsey and his officials that the stalling in setting up of the commissioning process has serious ramifications for the future of patient care.
"The main driver for change in what was to be the new health care environment was to be a revolution in commissioning.
"Some services are already being removed or withheld. One such being cognitive behavioural therapy, which according to one health trust is 'being suspended due to present uncertainty'," he said.