Hospital waiting lists are high on that ever-lengthening and depressing menu of health service problems that seem insoluble.
It's unsurprising that they command such attention when there are hundreds of thousands of public patients enduring delays across the country.
If promises made in January were followed through on, nobody should be waiting more than eight months for an operation - and they would suffer no longer than a year-long wait to see a consultant.
Instead, there is now a familiar frenzy activity to meet the latest revised deadline of an 18-month wait, a deadline which is supposed to be met by the end of this month.
There is a patchwork of outsourcing to private hospitals, as revealed recently in the Irish Independent.
There is also a frantic "validation" exercise involving crossing off names of people who have died or paid for their own treatment and the usual few weeks blitz of clinics. But we all know we have been here before, and it is Groundhog Day all over again.
The internal audits, carried out by the National Treatment Purchase Fund, of how hospitals manage hospital waiting lists, point to "persistent" problems, including failure to treat all patients waiting the longest first.
Outpatient clinics, which continue to waste valuable slots by the numbers of patients who fail to show up, are also not being run as per the rule book.
The hospitals reply that it is not that simple.
They are short consultants, nurses and for the first few months of this year had few beds for patients on waiting lists sitting at home for the phone call to tell them they can finally be admitted.
Many doctors also argue that they cannot simply work rigidly to the "next in line" order when it comes to setting a date for surgery.
Patients and their individual needs are too complex, and the person waiting three months as opposed to a year may be dead if they have to sit out their turn.
The waiting times are so long that a patient's condition can deteriorate while on the list.
Others end up having to come through the hospital emergency department and get operated on while they are still on the waiting list.
Forming hospitals into groups, to share staff and facilities, is the latest cure being touted for waiting lists. But the fear is that the groups, promoted as the next great white hope for so much of our health ills, will become another half-baked notion.
It raises the question: is there a case to revive the old role of the National Treatment Purchase Fund to just go out and buy surgical operations, and consultant appointments, for public patients to keep some lid on delays?