Last month, Northern Ireland's health trusts issued a joint statement setting out measures aimed at alleviating what was expected to be a challenging period over Christmas and into the early months of 2023.
The tone of the message was ominous. The chief executives spoke of being 'deeply distressed at the ongoing situation in our hospitals.'
They outlined steps that they said they never wanted or 'indeed imagined having to introduce.'
These included discharging patients no later than 48 hours after they were confirmed medically fit to leave and where a suitable place was available. A maximum three hour limit was to be applied on ambulance handovers at emergency departments while all available space was to be used throughout hospitals.
Despite these initiatives, the position within our hospitals, particularly A&E, remains extremely difficult.
Earlier this week, emergency consultant Dr Paul Kerr, who is based at the Royal Victoria Hospital in Belfast, told the Irish News the health service has experienced its worst winter on record and he expects the situation to worsen before spring.
Worryingly, he said it is clear people are losing their lives because of emergency delays.
He paints a dire picture of the scene within emergency units, of dozens of elderly patients lying on trolleys, unable to get pain relief at times or even to get to the toilet.
Emergency nurse Stephen McKenna yesterday described patients cared for in corridors, people being nursed 'head to toe, top to tail, side by side, crammed into spaces', with staff 'completely overwhelmed.'
He said: "There are people literally lying and sitting side by side in conditions that would otherwise have been completely unacceptable just five years ago."
By any standards, the healthcare system is the north is in crisis.
Short term measures will only take us so far. As the trust chief executives pointed out, what is needed is a long-term funding settlement and reform to effectively build capacity.
That requires political will, which is absent at present.
As we face this testing time for our health service, the public can do what they can by helping to reduce the spread of illnesses currently circulating. The Public Health Agency is also urging people to get their flu and Covid vaccines.
But we need to recognise that we cannot go on as we are, that change is necessary and urgently needed.
