It showed the wait for the most urgent patients was longer at emergency departments, there were worsening bed ratios and stagnant elective surgery waiting times.

AMA NSW president Brian Owler, not for the first time, warned that the states and territory health systems are facing a "black hole" from 2017 thanks to almost $60 billion in federal funding cuts over the next decade.

It's true that Premier Mike Baird has been leading the charge on advocating an increase to the GST with compensation for low income earners to plug the gap.

But it is also increasingly apparent he's not getting very far.

Facing an election this year, federal Treasurer Scott Morrison is now insisting that any potential hike in the GST to 15 per cent must also fund personal and company tax cuts.

The suggestion revenue from a GST hike can also fund the $80 billion gap in health and education funding is receiving an understandably cynical appraisal from Opposition Leader Luke Foley and others.

But we are not hearing much outrage from the government.

In particular, there has been a noticeable lack of fire from the woman with direct portfolio responsibility for the NSW budget, Treasurer Gladys Berejiklian.

Baird and Berejiklian's strategy has been and remains to negotiate behind closed doors with the federal government.

It was a strategy that made some sense when Tony Abbott was prime minister and Joe Hockey was federal treasurer.

Then, it was hoped that his close friendships with Baird and Berejiklian respectively might have helped things along at the negotiating table.

Now both are gone, replaced with a Prime Minister and Treasurer only too aware of the backlash that a budgetary shock like a big tax hike can deliver even for a government leading in the polls.

Understandably, they appear to be in no hurry to make the states happy at the expense of their own political skins.

It's time for NSW – and in particular Berejiklian – to switch strategy from appeasement to attack.

For while an appeasement strategy has risks for Baird, its dangers are exponentially greater for Berejiklian.

Consider that the impact of the federal cuts kick in from 2017 and the health funding gap rises significantly each year from there.

It's no secret that Baird is eying the exit – likely after the 2019 election – and that Berejiklian would be a front runner to replace him, likely with his support.

But on current projections what would she inherit? An impressive infrastructure program, yes, but also a disastrous fiscal gap in health funding estimated by Treasury to be about $7 billion a year by 2020 in NSW alone.

The dilemma for Berejiklian is that unlike Baird she is an ultra-cautious politician.

In much the same way as former premier Barry O'Farrell she is risk averse, likely because – again, unlike him – she sees politics as a long term career prospect.

But this natural caution has contributed to a remarkably low profile for a NSW Treasurer.

Her annual media appearances can be just about counted on two hands and she rarely takes the initiative to get out front of issues.

With the critical issue of health funding at stake, this needs to change both for her sake and the sake of NSW.

Berejiklian should be out there playing the bad cop to Baird's good cop.

Last year's budget gave a hint that even Baird realises her profile is in need of a lift when he appeared with her in a chatty video before the big day. It smacked of a "Let me introduce the Treasurer you've never heard of" moment.

Ironically it was the forward estimates in that very budget that captured for the first time the hit NSW is due to cop from the federal cuts.

Rightly or wrongly, Berejiklian's lack of public advocacy gives the strong impression she's putting party politics above the welfare of NSW.

It's apparent that Morrison is deeply uninterested in doing NSW any favours in relation to health funding.

With the pressure of a looming election as leverage, if Berejiklian was serious about actually fixing the situation, she would return the lack of favours – for both her and our sake.