Richard Pengelly, the person in charge of health and social care in Northern Ireland in the absence of a minister, has set out in stark terms the need for urgent reform to our current system.
He told a BBC documentary this week that if we keep going the way we are, in about 20 years the health service will need 'virtually all the money that's available to the executive.'
This is a warning from the top civil servant in the Department of Health that needs to be taken seriously.
We already know that our health service is under immense pressure. The waiting lists alone are quite shocking and while the dedication, skill and commitment of staff is not in doubt, they are having to deal with increasing workloads and squeezed budgets.
Even though we receive similar funding levels to other parts of the NHS, our waiting times are much longer.
Patients facing delays are entitled to ask why this is and what is being done to sort it out.
At the moment, the health budget is around £5 billion per year but it is clearly not enough to address a growing demand for a range of important services from an ageing population with complex medical needs.
Mr Pengelly has said that funding is only part of the problem and all services require change in how they are set up and delivered.
The Bengoa report has advocated transformation of our existing system, pointing out that while patients' needs have changed dramatically and indeed society has changed, our health service model is essentially stuck in the second half of the 20th century.
We need a service for the 21st century, one that delivers excellent care when it is needed, addresses health inequalities, offers new technologies available elsewhere and copes with rising demand.
Bengoa has provided a blueprint for reform and while it is never easy making tough decisions, it is patently obvious that our present set up is not sustainable and needs overhauled.
