It was said at a conference in Belfast that it was becoming increasingly difficult to deliver a health system that met the needs of people in Northern Ireland with existing resources.
The Permanent Secretary for Health, Peter May, said that without sustainable investment, society will have to reset expectations about the services the health and social care system can provide.
Mr May is effectively in charge of the Department of Health as Northern Ireland currently has no ministers following the collapse of the power-sharing institutions in Stormont earlier this year.
The health service under stress in Northern Ireland has faced significant budget constraints and mounting waiting lists.
Earlier this week, Northern Ireland Minister Chris Heaton Harris laid out a budget for Northern Ireland where he said he was increasing funding for health to “address critical pressures”.
Mr May was speaking at the annual conference of the Northern Ireland chapter of the Society for Healthcare Financial Management when he detailed the pressures facing the health and social care system in Northern Ireland.
He said, “There are fundamental questions waiting to be addressed regarding the provision and financing of health and social care in the future.
In the end, we get the health service we pay for.
We all want to get back to a health service that delivers timely care to everyone who needs it when they need it. This is far from a guaranteePeter May
“Without sustainable investment, we as a society will need to reset our expectations of what our health and social care system can deliver.
“We all want to get back to a health service that provides timely care to everyone who needs it when they need it. This is far from a guarantee.
“Without sustainable funding, that would be impossible.”
The Permanent Secretary added: “Of course, there are many measures big and small that we must take as a system to make health and social care more efficient and effective.
“We all know this.
“The recently announced drive to reduce agency personnel costs is one example of what needs to be done.
“We know that reshaping hospital services can secure better care and deliver greater value to taxpayers.
“However, we must not pretend that efficiencies alone will close the widening gap between demand and capacity.”
He added: “It is often said that you can judge a society by the way it treats its most vulnerable and sickest people.
“The fact is that today, with the resources available to us, we find it increasingly difficult to offer the necessary health and social care system to meet all the demands of the population.
“It is also true that population aging and advances in medical science mean that the gap between demand and capacity is growing year by year, and winter is winter.
“Those who work in health and social care are deeply committed to doing the best they can.
“It remains the case that the vast majority of patients receive high-quality care.
“At the same time, many people who need less time-critical care are forced to wait longer, often experiencing pain and discomfort.
“This is not the level of care that the public expects or that any of us want to provide.”