Editor's Viewpoint: Only radical change can cure ailing NHS
A year ago this month, the then Health Minister Michelle O'Neill outlined an ambitious 10-year plan to transform local healthcare, her report coming on the back of recommendations from Professor Rafael Bengoa on how to make the NHS more efficient.
Revealing her plan, the minister said that unless drastic changes were made by the end of the 10-year period, health spending would consume 90% of the budget.
One year of that decade has already passed and both reports are still gathering dust at Stormont.
Meanwhile, the problems in the health service continue to mount - lengthening waiting lists, rock-bottom staff morale and services at breaking point.
Our five health trusts recently launched a consultation on how to save £70m.
That will inevitably mean reduced services in the short-term.
We can expect the same next year and the year after and again and again unless the recommended transformation takes place.
At the moment the NHS is living in the economics of the madhouse, as our story on the cost of agency nurses in the Northern Trust area reveals today.
Each agency nurse that the trust employs costs a staggering £100,000 - four times what Trust nurses on the same grade earn.
The price paid to agencies for these nurses is often higher than the salaries of consultant doctors in the Trust.
Agency consultants can cost up to £300,000 - three times the salary of their staff colleagues.
The trust admits that such expenditure is not sustainable - it is trying to save £13m - but says that it has no option but to go to nursing agencies for staff because of a shortage of nurses.
While the agency nurses do not get all the money paid by the Trust to the agencies, it is not difficult to imagine that staff in the Trust are demotivated by their rewards.
Having endured a lengthy pay freeze as part of the Government's austerity programme, they are now only getting a 1% pay increase on pay levels that are already five years out of date.
Urgent action is required on the transformation plans for the NHS. A functioning Executive would be best placed to carry out this transformation, but direct rule ministers might have a greater will to take the necessary tough decisions, being unencumbered by pressure from constituents.