As Micheal Martin today outlines his vision of the future of the health services he will be speaking against a background of an increasingly creaky hospital system.
The Minister for Health and Children will tell health service managers and unions in Tullamore of the steps he believes are needed to modernise the way they work.
For now, patients and their families will draw little comfort from the Minister's aspirations. There's nothing like 16 hours on a trolley to knock the gloss off visions of the future.
Sixteen hours is how long the wife of a reader spent on a trolley in Beaumont on a recent Sunday waiting for a bed. Between patients waiting to be seen or admitted and their relatives, the reader counted another 62 people.
Another reader says his mother spent eight hours on a plastic chair in St James's Hospital waiting to be examined one day last week. The hospital cannot comment on individual cases but says that day was busier than usual.
Another reader complains of his wife waiting two months for an inpatient bed for breast cancer treatment. She had had two operations after the cancer was diagnosed but her consultant wanted to bring her back as an in-patient for a week of treatment. Two months later she still has not been able to get a bed and has commenced chemotherapy at a private hospital as an out-patient. Our reader wonders what happens to people with medical cards.
Breast cancer provides a particularly good example of an area of the health services that needs urgent attention. The Women's Health Council complained recently that tremendous stress is caused to women who have to travel from all over the State to Dublin or Cork for radiotherapy.
Nearly two thirds of women interviewed for the report said they got an appointment at a breast clinic within two weeks of being referred by a GP. But a quarter waited for up to a month and one in 12 for more than a month. The Minister has set up an advisory group to talk to health agencies about how to improve the service. That's good but the fact that it had to be done at all suggests a lot of "slippage" in the health system regarding services for people with life-threatening illnesses.
And people waiting desperately for services, or exhausted by travelling across country for radiotherapy, will hardly find much comfort in the inauguration of yet another committee.
In an effort to recruit more hospital doctors to train in anaesthetics, an officially sponsored delegation is to visit India and Pakistan next month. A shortage of anaesthetists has restricted epidural and resuscitation services in some hospitals.
The Eastern Regional Health Authority estimates that the region will need another 674 acute hospital beds and an extra 550 district hospital beds to provide for population growth, and the ageing of the population, over the next decade.
email: hospitalwatch@irish-times.ie Hospital Watch special on the Web: www.ireland.com/special/ hospital