Editor's Viewpoint: NHS crisis demands emergency response
The unprecedented decision by the Royal College of Nursing to ballot members in Northern Ireland on strike action is a clear demonstration of the demoralisation felt by nurses here.
According to the College, they have seen their pay fall by 15% in real terms in the last eight years and now lag behind their colleagues in other regions of the UK.
This goes some way to explaining why health trusts here have been unable to fill 2,600 nursing vacancies in hospitals and the same number in care homes.
The remedy by the trusts is to employ agency nurses but that has led to the scandalous situation where trusts have paid a single Scottish agency £43.5m in the last five years.
Little wonder NHS-employed nurses feel undervalued when agencies can afford to pay nurses an astonishing £59 an hour to work in hospitals on bank holidays.
It can be argued that the trusts have no alternative but to turn to agencies to fill the gaps on the wards. There is some validity in that argument but it should be noted that while the then Health Secretary for England and Wales Jeremy Hunt announced a cap on payments to medical staffing agencies in 2015, there was no similar limit imposed here by the then NI Health Minister Simon Hamilton.
That means that our trusts could be paying over the odds for agency staff at a time when the Health Service is under unprecedented strain through rising demand and shortage of NHS staff.
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It is little wonder that practically every day brings new stories on lengthening waiting lists for patients including those with even acute conditions.
Indeed last night a public consultation meeting was held to discuss the proposed closure of the acute stroke unit at the Ulster Hospital. There are fears this could put people living in rural parts of the Ards Peninsula at greater risk.
Clot-busting drugs for stroke patients are twice as effective if given in the first 90 minutes after a stroke than in the next 90 minutes.
For those for whom such treatment is suitable it can mean the difference between a near-normal quality of life or a lifetime of disability.
The remedy for the NHS's ills here lie at Stormont in the shape of the well-received Bengoa Report on health reform, but the absence of a devolved administration means it is gathering dust rather than breathing new life into a labouring service. Many would regard that as too high a price to pay for party ideology.