Another winter, another crisis for the NHS in Northern Ireland. A&Es are struggling to cope with greater patient numbers and the system in hospitals is backed up, as patients wait for care packages to help get them home.
The blame lies squarely with Health Minister Simon Hamilton and the rest of the Northern Ireland Executive. They constantly refuse to grapple with the problems or deliver much-needed reforms.
The healthcare system in Northern Ireland spends more money per head of the population than any other part of the UK, but its outcomes are the worst. Rather than make genuine changes to put things right successive ministers have asked for more money in order to provide a sticking plaster for far deeper problems.
The solutions are out there. The Donaldson Report, by the Chief Medical Officer of England, made 10 recommendations to radically improve how the NHS in Northern Ireland works. It noted that some hospital facilities here cannot provide high levels of care consistently because they are too small. Donaldson proposed that a safer system might mean some facilities closing, but he recommended that an international panel should decide how best to reconfigure services.
Another key observation found that the Executive's Transforming Your Care (TYC) strategy, which was supposed to deliver care closer to home and away from acute hospitals, had not been properly implemented.
This failure goes to the heart of our annual winter crises. More patients present at A&E because alternative services have not been put in place. Meanwhile, hospitals struggle to find beds for new admissions, because the types of care TYC proposed have not been put in place to let patients go home.
These failures are down to the Executive's reluctance to take decisions which may be unpopular in the short-term. We're likely to see another winter of inaction, too, as elections lie just around the corner in May, despite more money being available for reform thanks to lower energy costs. It's time for a change and voters can take their chance this year to shake things up at the Assembly.