Over recent weeks, media and political attention in Northern Ireland has focused on the increasing pressures in the NHS.
This includes significant waiting lists, failed cancer targets, the high percentage of patients diagnosed with cancer in an emergency department and the increasing pressures experienced by frontline staff.
Figures shared over the weekend show that, during September, only 49% of patients urgently referred with a suspected cancer began their first definitive treatment within 62 days. The official target is that 95% should receive treatment within 62 days.
Data from the NI Cancer Registry, obtained last week by BBC Northern Ireland, showed that one in five cancer diagnoses is being made in emergency departments (EDs), a situation that has arisen due to the longest waiting times in the UK across the surgical specialties.
Furthermore, it is very concerning that non-emergency surgery has been suspended in the Belfast, Southern and Western Trusts - and this is before the worst of the winter pressures begin. It means patients who may already have waited many months will lose any hope they had of getting a date for their operation, until the suspension is lifted. All of this highlights the "burning platform" outlined in the Bengoa Report.
These are challenging times with health and social care staff in Northern Ireland, who are working tirelessly to help patients in services that are, in places, on the brink of collapse.
The College recognises their unwavering commitment but is clear that any sustainable solution must include the support of our political representatives.
This is why we are asking our political leaders to commit to the following:
l Sustained additional investment in health and social care in to tackle waiting lists and other escalating pressures. It is true to say that money alone cannot solve the problems besetting our health service. However, it is equally true that lasting solutions to many of these problems will require significant investment. This is particularly true of waiting lists, as the Department of Health has made clear publicly;
l Reforming health and social care, even if these sometimes require difficult and controversial decisions. Report after report has identified the need for change. Important and detailed implementation work has followed the latest of the reports, by the Bengoa panel. Much more is needed in the years ahead and our politicians need to dispel the suspicion that they will always shy away from making changes to services;
l A frank and far-reaching public debate on budgetary priorities in health and across our public services.
A recent Nuffield Trust report on the local health service noted that "a squeeze on health and social care as rising demand meets strained public funds is a reality not only across the UK but across the developed world, from the United States to Japan. It is a problem that will not go away soon".
We all need to decide the best ways to generate and deploy resources for vital services. This is a society-wide challenge and our politicians can help lead the way.
With the best interests of our patients at heart, it is essential that we address these problems with a renewed collective vigour and the urgency they require.