A leading doctor has warned of the challenges facing Northern Ireland's health service at a major national conference.
On the final day of the British Medical Association's annual conference in Harrogate, Dr Paul Darragh outlined the potential problems in a keynote address.
Dr Darragh, BMA (NI) Council chairman, told 600 doctors from across the UK that Northern Ireland was currently engaged in the "greatest reconfiguration of the health service" in recent history.
"We face the pincers of demographic change, a rising tide of obesity and new medical technologies, while at the same time being constrained by the financial squeeze in real terms of a massive cut in funding for healthcare provision," he said.
Dr Darragh warned that doctors will not be "an observer" when it comes to contributing to Transforming Your Care, the Executive's vision of overhauling the health service.
This is the major initiative driven by the Department of Health in Northern Ireland which aims to move more care from the hospital into the community.
He said the BMA (NI) had secured an "influencing position" to help implement health policy.
"Transforming Your Care is very much a work in progress and in order to succeed, Government needs to actively and effectively engage doctors in the planning and implementation of change in the very services in which they work day and daily," he said.
"BMA (NI) is positioning itself in the centre of those changes
"BMA will not be an observer or a passive participant, but a driver and shaper of any change."
He also highlighted the cross-border health initiatives the BMA was involved in.
These include organ donation, minimum unit pricing of alcohol, health inequalities and men's health issues.
Other key topics discussed at the four-day conference included problems facing GP practices due to funding.
It was warned that general practice in the UK was "imploding", with patients often waiting two weeks for appointments.
Delegates at the annual conference also voted in favour of a motion to prohibit smoking to anyone born after 2000.
But Dr Darragh highlighted doctors' commitment despite facing ongoing pressures.
He added: "BMA (NI) remains committed to protecting the profession because only in this way can we protect the health service and secure the best possible care for our patients."
The annual representative meeting brings together doctors to debate motions on various aspects of their working lives and professional practice.
Among the key motions delegates at the BMA annual conference voted in favour of was to prohibit smoking to anyone born after 2000.
The BMA is now expected to start lobbying the UK Government to agree to the move.