1987. Yes, that is when I saw the posters. King Charles of Kinsealy was on the election trail warning Health cuts would wreck the lives of the old, the sick and the handicapped. He won. And there were health cuts. Plus ça change.

What kind of cuts? Bed closures. That crude physical manifestation that medicine was being taken for our own good. Short term pain for long term gain. So what if waiting lists are building up, we like this kind of short sharp shot of action. The next minister will fix it by promising the earth. This is how we do things here.

Since 1987 there have been some really heavy hitters occupying the top floor of Hawkins House. Michael Noonan, Brian Cowen, Brendan Howlin, Micheál Martin, Mary Harney, James Reilly... Some of the best and brightest. Many became hostages to fortune and are remembered for one specific event. Noonan allowed Hep C destroy his early political promise. Cowen will forever be remembered for his Angola remark. Micky M banned smoking. Ms Harney was driven to distraction while James Reilly never got tired of saying, ‘trust me I’m a doctor’.

They also had one thing in common. None of them actually had a view on what a health service looked like. We looked longingly eastwards to the NHS. Where reform happened, it was purely nameplate switching in Ireland. We paid lip service to community care and all that should flow from it. Then the deficits began to grow and grow.

November was viewed with dread. Sick people were unaffordable luxuries. This mindset has led us to where we are today.

It seems facetious to say it but we need a plan. One that is thought out. One that realises people get sick (that is much more worthwhile than ‘patient focussed’), if we want an insurance-based system, so be it. If we want a free to all sytem, lets talk that through. We need a plan.

Having a plan would be a start.