Rocketing waiting lists for hospital appointments are a clear sign of "management failure" affecting the most vulnerable, it has been claimed.
And concerns have been voiced that the growing problem of people facing months waiting for a first specialist appointment needs to be a priority for the Health Minister Jim Wells before it "spirals out of control" even further.
The ailing Department of Health, Social Services and Public Safety has to find £70m to break even by April. But despite the pressures, former UUP Health Minister Michael McGimpsey said the trusts had shown an "inability" to adequately deliver resources and patients were suffering.
"Staff have been working heroics to keep the show on the road but the fact is the system is not robust enough. We saw the figures in September for the summer months, and it was mild, and things are beginning to get beyond us and get out of control now. I would be very, very concerned and if I was minister.
"I would be looking to see how I would take control of this, not least by investment and even bringing in staff on a temporary basis to boost the workforce and ensure we have the numbers there to deal with the spikes in demand."
However, the member of the Stormont health committee said the situation can be addressed: "This can be dealt with and can be managed but you need the right number of people at the right time with the skills and that is very often a resource issue.
"This is one of the consequences of over three years ago when there wasn't enough money put into the health budget.
"The system has been crumbling at the edges ever since. This situation is clearly spiralling."
Dr John O'Kelly, chair of the Royal College of GPs, said given the proposed health cuts and contingency plans they anticipate the waiting times will continue escalate over the next year.
"It is incredibly frustrating, especially for patients. One of the questions you can get asked when you see a patient when you made a decision that they need a referral is 'Well, how long will that wait be?' And you can't tell them because we don't know. What we could say is a few months, but it's getting longer and longer."
He added the patient might be forced to attend A&E the longer the wait goes on.
"They could finally have to be referred to a 'red flag' list if their condition becomes serious," he added.
Fearghal McKinney, SDLP member of the Stormont health committee, said the waiting times were "totally unacceptable".
"This is not always down to money. It is down to systems and management and in this case management failure - and a failure of vulnerable patients."
He added: "When the committee quizzed the departmental officials they were able to give us headline knowledge of what happened but when you drilled down they couldn't tell us why things were happening.
"In that context, and in the backdrop of the spiralling figures, it is completely unacceptable. The department will have to explain why this is the case and how it is going to act in order to do something about it."