A decade ago Northern Ireland’s health service was likened to a “burning platform” – where there was such urgent pressure that “standing still is no longer a viable option”.
The man who described it that way, Prof Raphael Bengoa, published a 2016 review, external that was supposed to change the way Northern Ireland does healthcare.
His proposition was practical but ambitious: that a system under relentless pressure could not simply treat more patients, run similar services in different hospitals and spend more money.
The name Bengoa came to represent something that Northern Ireland’s health service desperately needed: the possibility of improvement and change.
A shift in emphasis was needed, he said, towards prevention, integration and keeping people well in the community, which would require the support of GPs.
But 10 years on, hospital waiting lists, access to GPs and the state of social care suggest the job is far from finished.
While political parties say they continue to support the Bengoa ethos, with an election looming next year some actions suggest differently.
The man himself is back in Northern Ireland for a fourth time.
Speaking to BBC News NI he said there was no reason why Stormont politicians could not embrace transformational change to bring about a world-leading health service.
“They have to agree there is something that is above their political parties and that is what happened 10 years ago,” he said.
“The most important green shoot 10 years ago was the political parties getting together and agreeing and putting a budget in place to support the plan.
“It would be great to see that consensus happening again with a budget that runs over three years to allow for long-term planning.”
Bengoa also said the role of GPs was critical if the new neighbourhood health model – to deliver more care in the community – is to be successful.
He said GPs were key to prevention and reducing pressure on hospitals and that their role in that must be recognised.