It's imperative the NHS time bomb is remedied
After the latest plan for improving health services in Northern Ireland was published - the fourth in 15 years - there does seem to be a greater determination to implement change. The time for kicking this particular can down the road is over, even if the proposals cover a 10-year period into the future.
In truth, there is no option but to do something radical. Health Minister Michelle O'Neill put the current crisis in the service into stark perspective. Without change the NHS will in 10 years' time consume 90% of the entire Northern Ireland block grant, an obviously unthinkable spectre.
But even leaving aside budgetary considerations, the imperatives for change keep mounting. Waiting lists are unacceptably high, care in the community is creaking and GP services are also under considerable strain, with the province now having fewer family doctors than in the 1950s.
There are some indications of how services can be improved, but in general detail is scant. The private hospital sector can help shorten waiting lists in the short term, and some more GP training places are to be offered. Primary care is also to be strengthened, with more professionals in health and social care being grouped together.
However, the problems in the service go much deeper. Previous plans proposed that we have too many acute hospitals, but politicians have always shied away from closing services in their own hinterlands in case of unfavourable voter reaction.
There is a difficult balance to be found when it comes to hospitals - ensuring that there are acute centres of excellence which are readily accessible to those living in rural areas. The present configuration, which is chiefly based in the large urban areas, is not ideal and it may be those areas which will come most sharply into focus in the next decade.
Of course it must also be remembered that health care when it is delivered is of a high standard. The problem is meeting the demand and that will grow sharply in the coming decade. The population is expected to rise to two million by 2024 and the over 65s - prime users of the health service - will increase by at least 26%.
That means that the minister will have to plan for increased demand, not just to make the NHS fit to meet current needs. The DUP and Sinn Fein seem as one on what needs to be done. But can they deliver? They dare not fail.