Opinion: GP shortages a symptom of wider problems
When the music finally stops on the game of musical chairs at Stormont, the new-look executive will be left facing some familiar problems.
The overwhelming need for health service reform was again highlighted recently with figures showing that one in four people are now languishing on hospital waiting lists, many of them in daily pain.
And away from the political theatre of the DUP's ministerial reshuffle this week came another alarming demonstration of the intolerable pressures the system is experiencing.
This paper revealed how the 'Beldoc' out-of-hours GP service was unavailable in the city of Belfast during periods last weekend.
There have been difficulties attracting doctors to cover night, weekend and holiday rotas despite rates of up to £100 per hour.
While GP shortages have been a high-profile issue in rural areas for some time, it is believed to be the first time this service has been suspended in Belfast.
SDLP assembly member Justin McNulty has called today for an urgent rethink of out-of-hours services after being "gobsmacked" to learn that almost 6,000 shifts in the Southern trust area have gone unfilled in the last three years.
If no doctors are available at the first point of contact, it is inevitable that further strain is placed on already hard-pressed hospital emergency departments.
While the number of GPs has risen in recent years, the increase has been outpaced by demand.
Staff say they are working long hours and suffering stress and ill-health themselves.
It is not a surprise that many are choosing to retire early or work part-time, and are unwilling to provide out-of-hours cover.
Pressures have been exacerbated by the Covid pandemic and doctors have warned that a full return to face-to-face services may never be possible.
As with waiting lists, the answer lies in long-term transformation of how our health service meets patients' needs.
Hospitals are already attempting to triage patients before they reach their doors to take pressure off A&E units.
At the primary care level, multi-disciplinary teams - where GPs work alongside physiotherapists, social workers and mental health practitioners - are also attempting to ease workloads.
It represents a welcome shift in focus towards early intervention and prevention, and one which should have knock-on benefits throughout the system.
The prescription for the ailing health service has been clear for many years. The question is whether the latest occupants of the executive table have the resolve to take the collective action required.