Indications that the out of hours GP service is on the brink of collapse in some areas are deeply alarming but should not come as a surprise.
We have been reporting for over a year on the enormous difficulties involved in accessing a GP outside regular surgery opening times and the problems are clearly getting worse.
As our coverage yesterday confirmed, it has regularly become almost impossible to make telephone contact with a doctor in Belfast and other districts in the evening and in particular at weekends.
Patients wait for hours before even getting through to the main centres only to be eventually told that no GPs are available and, if they cannot wait until their surgery reopens, they should attend their nearest accident and emergency department instead.
Of course, as has been well documented, putting a call in to overstretched surgeries during the normal working week is also a very slow and stressful process for all concerned.
It needs to be accepted on all sides that visiting a hospital, where lengthy queues are inevitable and urgent cases must be given priority, should be regarded as a last resort, but our dysfunctional structures mean that those who require any form of pressing medical treatment are increasingly left with no other option.
The out of hours GP service which patients have relied on for decades is approaching the point of no return, with ordinary surgeries heading firmly in the same direction.
As many long serving doctors approach retirement age, with very few new recruits in the system, it is obvious that we are approaching a full blown crisis.
Established practices are already closing in both urban and rural neighbourhoods, and those which remain are facing the prospect of taking on unsustainable numbers of patients.
The health minister, Robin Swann, faces an unenviable range of issues in a region where waiting lists are already among the worst in Europe and almost 200,000 people are waiting over a year for a first hospital outpatient appointment.
A concerted programme of investment across the health sector is an absolute necessity but this can only happen with the support of a fully restored and credible devolved administration.
The idea that such vital measures can be placed on indefinite hold because of political wrangling over protocol arrangements which were the unavoidable consequence of the Brexit debacle is almost beyond belief.
