Mary Harney must consider her position. Of course she is not personally responsible for the shocking fact that almost 58,000 X-rays in Tallaght Hospital went unread by consultant radiologists over a four-year period.
That, however, is exactly the point.
As Minister for Health, she has created a system where nobody seems to take responsibility for any of the scandals that crop up on a regular basis -- and after this latest horror story, the scale of her failure is clear for all to see.
Whenever a political disaster such as this one is exposed, the standard excuse is: "Well, at least nobody died." In this case, however, somebody already has.
Another person is undergoing treatment for cancer, while over 14,000 more are due some sleepless nights as they wait to be told if their X-rays can be given the all-clear or not.
It all adds up to an amazing dereliction of duty from one of the most prestigious hospitals in the country -- and the really scary thing is that if it could happen there for years, there's every possibility that something similar could be happening elsewhere today.
In fact, this is just the latest in a long line of diagnosis and oversight failures that have taken place within the HSE ever since its creation in 2005.
The most shocking of all was uncovered at the Midland Regional Hospital in Portlaoise in 2007, when nine women who had cancer were led to believe that everything was all right. In terms of scale, however, this is by far the worst we have yet seen and suggests that absolutely no lessons have been learned from all these previous debacles.
While a full independent inquiry will be needed to find out exactly how this could have happened, we already know that the hospital, the HSE and Harney have been aware of the problem since December.
So why are emergency meetings only taking place today? Why was no helpline put in place until this morning, several hours after the media had broken the story? Why has the Minister apparently done nothing to find out who could have been responsible? And most importantly of all, where does the buck stop?
All these questions go to the heart of what is wrong with our health service today. When Harney amalgamated the old health boards into the Frankenstein's monster that is today's HSE, she effectively stripped herself of any real power. Since the new body is notoriously secretive and riddled with bureaucracy, this means there is no longer any political accountability when tragedies such as this one occur.
This was borne out yet again last week by the political row over the unpublished HSE report into the appalling death of 18-year-old Tracey Fay.
Not only did Barry Andrews reveal that several other kids had died in State care without any reports at all being commissioned, the hapless Minister of State for Children was forced to admit that he had no real power to make anything happen.
A clearly floundering Mary Harney protested this morning that it was not her job to meddle with HSE business, which raises the obvious question of why exactly we have a Minister for Health at all.
Until now, the consensus in political circles has been that Harney would probably hold on to her job in the Cabinet reshuffle that's now expected to take place on the 23rd.
Brian Cowen apparently likes and respects her. Today, however, even this Taoiseach must realise that she has become a massive political liability -- and this will be the best chance he ever gets to replace her.
There's been a lot of talk this week about the "cringe factor" surrounding Mary Coughlan. In the case of Mary Harney, however, it's more like an outrage factor.
The Tallaght X-ray scandal has underlined this embarrassing truth yet again -- and if there's any justice, it should be the final nail in her political coffin.