Questions must be asked about why a critical care hospital remains mainly closed six years after it was due to open, a former NI commissioner for public appointments has said.
All 12 floors of the £150m hospital in the grounds of the Royal Victoria Hospital were due to open in 2012.
However, only the Emergency Department is operating, leaving the other 10 floors under construction.
The Belfast Health Trust says the project remains within its budget.
Felicity Huston, the former Northern Ireland commissioner for public appointments, said the trust's board needed to ask questions.
'Heads would roll'
"It would very much suggest - looking at the written evidence anyway - that the board really aren't exercising their role holding the chief executive and his or her staff to account for what is happening, or in this case, what is not happening," she said.
Some operating theatres are still being commissioned and building defects are subject to legal action between the trust and a contractor.
Problems highlighted by BBC News 12 months ago around sewage and ventilation continue as does major construction work carried out by different contractors in order to bring the building up to standard, at that stage 10 of the 12 floors remained unopened.
A year later, and the trust still cannot say when the building is due to fully open.
According to sources, the building will not be fully operational before the end of 2018.
Ms Huston said matters are treated differently in the private, commercial world.
"I would imagine that heads would roll. Certainly bonuses would be cut, targets would have been set and, if they hadn't been met, I think people who hadn't met those targets would be feeling the pinch."
Ask health professionals about the critical care building and many have to be reminded about it.
By all accounts, it has fallen off the radar. A senior doctor within the Belfast Trust told the BBC that it is known as the "big white elephant that everyone has written off".
The BBC understands that work finished in 2017 has had to be redone this year in order to comply with building regulations.
This includes theatres being redesigned as they were originally too large to cope with the ventilation system that had been installed.
The new work includes partitioning walls in order to make them smaller and more manageable.
As some work has had to be redone due to the delay, this has meant many rooms and corridors have had to be repainted as air ventilation plants were ripped out.
In addition, the helicopter landing pad at the critical care building is still not operational.
The Belfast Trust said the work that needs to be done "is a requirement to meet CAA (Civil Aviation Authority) accreditation" and includes fire safety work, additional lighting requirements and communication infrastructure.
A local GP, whose surgery sits in the shadow of the critical care building on Belfast's Falls Road, said it seems no-one is being held to account.
Dr Michael McKenna said that no-one seems to be asking any questions.
"You have to remember this is public money that is being spent and that is £150m that is not being utilized in any shape or form."
He said the health trust is responsible for the building and added: "It would be nice to have ongoing information to know what is happening, and if there is an estimated time of when it might be in use because it is absolutely needed."
As reported by BBC News last March, legal proceedings between various contractors and the trust have been ongoing during most of the building work, with one source describing litigation as "acrimonious".
'A long time'
However, they did go through a mediation process with the contractor and a settlement was reached that ensured that there was no loss to the public purse.
"We acknowledge that the critical care building has taken a long time to complete, and given the length of time involved it is important to bring the public up-to-date with the current status of the building," the trust said.
It said it was working through a list of remedial work to address defects discovered since handover, and changes in standards since it was designed.
"We are also bringing the ventilation system to the required standard in accordance with guidance before the theatres are put into use," it added.