One of the biggest political breakthroughs in Northern Ireland since the advent of devolution in 1998 happened last year after the publication of the Bengoa report.
The report urged political leaders to press ahead with urgently needed NHS reforms.
Such reforms had been recommended by one report after another, stretching back more than 15 years, all pointing to the Province having inefficient hospital provision.
Whenever there was any attempt to do anything about it, and perhaps close a unit so that services could be concentrated in a new top rate facility, there was cross-party political opposition. This meant that reform was essentially impossible – any closure would be opposed by one party, and then in a panic by them all, and so the wasteful provision would go on and on.
But last year the many parties agreed to jettison that approach and jointly support the increasingly urgent reforms, as NHS costs spiral amid demographic change.
That informal agreement between the parties was hardly a sign of political courage on the part of any one party. But it was a significant change on anything that had gone before. Significantly, Sinn Fein – which is always demanding limitless UK taxpayer funding for a long spending wish list – was also prepared to implement reform.
The party did so even as it held the health ministry. Sadly, however, another less constructive instinct in the party got the upper hand and it brought Stormont down instead.
Now it has emerged that cancer waiting times have again been missed. This failure is not directly linked to Bengoa. But unless radical NHS reform is embraced, there will be many more missed targets in a range of specialities within the health service in Northern Ireland. Throwing endless money at the NHS cannot meet its ever growing demands unless we are all willing to pay thousands of pounds more a year in tax.
It is not too late for the constructive voices in Sinn Fein to stand up to the destabilising ones.