Edwin Poots needs to review his health strategy
Health minister is one of the toughest jobs in any government and the stress is affecting even our own famously thick-skinned Edwin Poots.
Resources are never enough and success brings problems with it. The longer life expectancy rises, the more expensive it becomes to treat the diseases of old age and the further medicine advances, the more it costs.
In 1944, UK life expectancy was under 65. Today it is over 80. Those extra 15 or 16 years cost a lot of money and the price is going up. The cost and range of all the medical interventions and tests which help people stay alive longer in the first place is also rising.
In Northern Ireland, health takes up about 40% of our budget and we could easily spend more. This is the context of Mr Poots's problem, just like every other health minister.
When he was first appointed, he had good ideas for handling finite resources. There was talk of more care in the community, more local units to treat minor injuries and the concentration of major A&E services in a few well-resourced centres. It hasn't worked out in practice.
More and more patients are being turfed into a few A&E facilities by GPs and the local centres to take the strain haven't materialised.
Frail old folk are being encouraged to remain at home as residential facilities are squeezed, but care teams aren't being given enough hours to cover their caseload properly.
As someone who has been in hospital a few times in recent months, I have seen that staff are doing their best and the level of expertise among specialist is high, but there aren't enough beds and there is no spare capacity in the system to handle the slightest surge in demand. Everyone knows this.
Emergency procedures are being invoked when it isn't really an emergency – just a busy night. We have shocking cases like Mary Anne Hood (above), whose broken back wasn't initially noticed in the Ulster Hospital, Dundonald and in the Royal, arguable our major regional hospital, there are inquiries into deaths during trolley waits.
This is no way to run a health service. Mr Poots needs to go back to his original plans and see if he can implement them in a more effective and holistic way.
In the short term, at least, that will mean arguing for more resources.