The health service in Northern Ireland is in severe difficulties. Waiting lists for treatment are at unacceptable levels while the GP service is facing an unprecedented crisis, with surgeries closing and a shortage of doctors willing to take on rural practices.
Add to this appalling trolley waits at our emergency departments, a lack of available beds due to patients unable to be discharged into the community and financial constraints affecting all aspects of healthcare.
Only last week this newspaper reported how funding for robotic equipment used in pioneering prostate cancer treatment in Britain and the Republic has been turned down in Northern Ireland.
In a letter to the Health and Social Care Board, one of the north's most senior doctors, Dr Michael McBride, warned of problems in recruiting and retaining specialist staff if the local health service is unable to keep pace with clinical advances.
Against this backdrop comes the row over the future of the emergency department at Newry's Daisy Hill Hospital.
Last month the Southern Trust warned it was considering overnight closure because of a shortage of permanent senior medical staff at the unit.
However, local people and political representatives are worried that any closure would lead to a long term run down of the emergency department and the eventual loss of Daisy Hill's acute hospital status.
Of course, any responsible health authority has to make contingency plans when faced with an urgent problem but sending patients to Craigavon - as was suggested - is not necessarily the best option.
As we reported last week, recent Department of Health figures show that Craigavon has failed to meet waiting time targets at its A&E with 181 patient waiting 12 hours or more in January alone.
It is hard to see how Craigavon could reasonably cope with a sharp influx of additional patients from Daisy Hill while the strength of feeling among local people on this issue has been made abundantly clear.
The trust has now postponed its plan to reduce hours at Daisy Hill's emergency department but it is still not certain what the future holds.
A meeting hosted by the Department of Health and involving key agencies including the ambulance service will be held behind closed doors today but it is essential any decisions are fully transparent and subject to scrutiny.
There is no doubt that several strategic reports on the future of the health service in Northern Ireland have signalled a need to reduce the current number of acute hospitals.
However, any discussion about the long term status of major hospitals and the centralisation of services has to be part of a comprehensive, properly thought through review and not some sort of piecemeal process.
In the meantime, and in the absence of a Stormont health minister, the authorities must look at ways to maintain the emergency department at Daisy Hill.
