John Compton: We must act now or a full-scale health crisis awaits... if we haven't got there already
Over the past week, Northern Ireland has experienced previously unknown levels of strike and work to rule action by thousands of health and social care employees.
Worse is to come. On December 18 a day of strike action across the province is planned.
Already thousands of patients have had appointments, diagnostic tests and routine surgery postponed.
Chief Executives are warning about patient safety.
There is very little Christmas cheer in our health service this year.
Recrimination is thick in the air. Staff organisations saying enough is enough in respect of pay. Management claiming they can't make the offer to staff they want without extra resources and political direction. Politicians, not in Stormont and seemingly powerless, apparently able only to comment from the sidelines. The Secretary of State indicating health is a devolved matter and not intervening.
What a sorry state.
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So it is left to those who are at the sharp edge of all this, the patients, to grin and bear it, living with their worry, concern and pain.
What does all this tell us?
It's quite clear we are stumbling inexorably towards a full scale crisis.
Not only is there an apparently irreconcilable pay issue but we have waiting lists which are nothing short of a disgrace.
In fact, so long are they that waiting times have become meaningless.
In social care we are increasingly overwhelmed by how to meet the needs of our elderly population.
In addition, many cancer patients are receiving treatment well outside the designated time.
The list could go on.
So once again it is patients and their families left to get on with it, making the best of, what for them, is often a very difficult set of circumstances.
So what should patients and families do or expect?
Simply shrug their shoulders and adopt the role of the victim who is defeated by the sheer scale of the task?
I think not.
I once had a boss who used to say in difficult situations: "It's time to get a grip and take control."
Never was this advice more relevant to our health service.
This should be the demand of our patients to all concerned.
Let's start with the politicians.
It is the duty of the Secretary of State to act, given our political context.
He may not want to but it is his obligation to do so.
Simply put, he should initiate a process to sort the pay issue.
This begins with a sense of the restitution of trust between the parties created by a meeting, chaired by him, with those various parties involved.
Appointing a Chair then, reporting to him, to continue to meet with the parties with the authority to create a practical, workable solution to the pay issue over a six to eight week period.
Demand from our local political parties to agree to a mechanism on how to approach sorting out our waiting times and the myriad of other compelling health issues.
There is nothing to stop this.
They are all committed to depoliticising health, and have a shared and agreed reform agenda.
Surely creating an advisory or executive board of party spokespersons, to work alongside the Department of Health, does not interfere with the talks about devolution.
Ask those working in the service to step back from the abyss.
Take time out for the six to eight weeks for a cooling off/negotiating period. This is a big ask but it's easy to stumble into the type of conflict we appear to have entered into, and often difficult to find a way out.
Everyone should be very wary of where it leads to and the untold personal damage that will inevitably follow.
The health and social care system in Northern Ireland is a fantastic institution with caring, committed employees.
Right now, whatever you think about the rights and wrongs of how it got to this place, without some serious intervention the end result is that the politicians and our healthcare system will be complicit in making it a truly miserable time for patients and their families, and as a society we will all be diminished as a result.
John Compton is the former chief executive of Northern Ireland's Health and Social Care Board