By Dot Kirby BBC Northern Ireland health correspondent

Both had been rattling around different meetings, consultations and strategies in the health service for so many years that there was considerable relief that, at last, a decision had been made.

Once again for the entire year, Northern Ireland's hospital waiting lists continued to be the worst in the UK.

Although the figures did fall by 10%, the queues proportionally are still much longer than other places.

The RVH was favoured for the Belfast maternity unit

And the number of trolley waits continued its upward trend.

Trolley waits are those people who wait on a trolley in accident and emergency departments - waiting for a hospital bed to become available.

Once again during the year, this figure hit another record high.

Acute care

The first direct rule minister out of the trap was Des Browne. In February, he announced the future direction of emergency hospitals in Northern Ireland.

He said there were too many acute hospitals for the size of the population and, in future, services would be concentrated on nine key hospitals.

One of these would be built somewhere to the north of Enniskillen in County Fermanagh.

Des Browne also said he wanted to see some acute care continue at an 11th hospital - the Downe in Downpatrick

He also said a 10th hospital - the Mater in Belfast - would continue to provide acute care for some time to come.

His decision also detailed that the Tyrone County hospital in Omagh would lose its acute services.

Unsurprisingly, this decision went down like the proverbial lead balloon in the Omagh area and the year ended with a family doctor from Carrickmore topping the poll with 6,158 votes in the assembly election for West Tyrone.

Dr Kieran Deeny has pledged to do all he can to retain acute hospital care in Omagh.

Lengthy waiting lists

Mr Browne also said he wanted to see some acute care continue at an 11th hospital - the Downe in Downpatrick.

With the newly-elected assembly members not likely to sit any time soon, implementing such huge decisions will be dependent on the willingness of direct rule ministers to drive through change

It would lose emergency surgery and consultant obstetric services, but keep 24 hour accident and emergency and acute medical beds.

These announcements were made against a backdrop of rising need - and lengthy waiting lists.

At the end of June, the current health minister, Angela Smith, pronounced on the long-running battle between the Royal and City hospitals in Belfast.

It was over which should offer a maternity unit in the centre of the city.

The minister - saying she was announcing the decision of her predecessor - plumped in favour of the Royal.

But she accepted that a new hospital would have to be built.

There is no date as yet for work to begin on this hospital - it is likely it will not open until the far side of 2010.

Apart from these two key decisions, it has been a quiet year in health.

Dr Kieran Deeny topped the poll in West Tyrone

With the newly-elected assembly members not likely to sit any time soon, implementing such huge decisions will be dependent on the willingness of direct rule ministers to drive through change.

Under devolution, Sinn Fein health minister Bairbre de Brun had been in favour of a new hospital in Enniskillen, rather than Omagh - and she had wanted the Royal to win the "baby battle".

Now that the assembly's complexion has so radically changed, it will be interesting to see to what extent direct rule ministers are prepared to implement such controversial decisions.