By BBC Northern Ireland's health correspondent Dot Kirby

The new devolved Assembly comes into being at a crucial time in Northern Ireland's health history.

Previous government ministers have admitted that tough decisions have been ducked for many years. Some decisions are now at crisis point.

The first key priority for the new health minister, Bairbre de Brun, and her colleagues on the health committee, chaired by Dr Joe Hendron of the SDLP, is to decide on maternity services in central Belfast.

For some years, there has been broad agreement that either the Royal Maternity hospital or the Jubilee unit at the City hospital should close.

The argument is that it is costly to duplicate the two services so close together.

In the past, health ministers have over-ruled each other as to which unit should close, ending with Tony Worthington deciding to opt in favour of the Royal.

But a Jubilee mother, Clare Buick, took the decision to court and won a judicial review on the basis that the Department of Health had not adequately consulted the public before over-turning the previous ministerial decision.

The department was forced back to the drawing board and consultation on four options for the future of maternity services in central Belfast ended in November. A decision is now awaited.

It is needed soon because the plan is to use the site of the Jubilee for Northern Ireland's new cancer centre and it is hoped clearing the site can begin at the latest in the early part of the New Year so that the centre can be ready for patients in late 2003.

Rural care

Rural hospitals are the one issue everyone knows about and it could prove to be the most controversial decision that the Assembly will have to take.

Northern Ireland currently has 17 acute hospitals. There is a plan to reduce that in the long term to just nine.

The argument is that although many people will have to travel further to get hospital care, they will get better treatment when they get there.

Under threat are hospitals in Dungannon, Magherafelt, Downpatrick, Whiteabbey and in the long term the Lagan Valley in Lisburn and the Mater in Belfast as well.

In the south west, either the Erne in Enniskillen or the Tyrone County in Omagh will close or both will go to be replaced by a brand new hospital on a green field site.

When the new Causeway hospital opens to patients in November 2000, it is planned Coleraine hospital will close.

Restructuring

Reorganisation of how the health service is structured is another key priority for the Assembly.

Plans are on the table to abolish the four Boards and replace them with five health and social care partnerships.

They also place more of the power and more of the rationing decisions with primary care groups involving GPs, social workers, and community nurses.

However, before deciding on that, the Assembly may want to take an even more root and branch approach.

It may want to look at abolishing the internal market in the NHS altogether.