Professor Niamh Brennan is correct to express concern at the apparent lack of progress in implementing the recommendations of the Commission on Financial Management and Control Systems in the Health Service which she chaired.
In making her views public, she has exposed a fundamental difference in the mindset of civil servants, their political masters and those who appreciate that reform of the health system is critically overdue.
The Commission, established by the Minister for Finance in April 2002, was a model of efficiency. It met on 17 occasions and finalised its report in January 2003. Yet it took the Government a further five months to publish the report. Now, Professor Brennan says she is wondering why there has been so little evidence of activity since June.
At that time, it was stated that an implementation steering group, headed by a chairman, would be appointed "shortly". There was also a promise of the establishment of an interim health service executive.
The relatively leisurely approach adopted by the Department of Health in furthering the work of the Brennan Group is at odds with the obvious effort made by Government ministers to be seen to be working "as usual" during the summer months. It suggests a gulf between image and reality.
The failure to move expeditiously on Brennan has wider implications. A National Task Force on Medical Staffing, chaired by Mr David Hanly, submitted its report to the Minister for Health before the summer. Its publication is still awaited.
Arguably the most important of a trio of reports informing the future of the health system - along with the Brennan and Prospectus documents - its findings will be central to the core issue of patients receiving a consultant-delivered, rather than a consultant-led, health service.
Hanly, however, faces an international deadline. The EU working time directive, which will limit the working hours of the Republic's non-consultant hospital doctors, comes into effect on August 1st, 2004. In order for this to happen, and for the juniors' hours to be filled by doctors of consultant status, Hanly's recommendations must have been implemented. Such a fundamental change to the way hospital doctors work - even with the best will in the world from all sides in the resulting contractual negotiations - will make the EU deadline a challenging one.
There is also the issue of credibility. Some observers have remarked that Hanly will go the way of previous landmark health service reports, such as Tierney and Kennedy, and be shelved because of the impossible challenges it poses. This would be a pity.
Having published the Health Strategy two years ago to acclaim and goodwill, now is not the time for the Government to choke on its responsibilities. The parlous state of health care in the Republic requires nothing less than immediate and vigorous action.