As she stepped into her ministerial car waiting outside the NSW government offices on Friday afternoon, Jillian Skinner was all smiles for the media. But it was a very different Skinner inside the meeting she had with Premier Gladys Berejiklian a couple of days earlier, according to sources familiar with the encounter. Skinner gave Berejiklian an ultimatum: let her remain health minister or she'd quit politics altogether, handing the government a byelection in her seat of North Shore to go with the one it already faces in Manly after Mike Baird's retirement. This would not have come as news to Berejiklian. Skinner's possible reshuffle out of the health portfolio and her threats to quit had been openly discussed by her colleagues for months under Baird while he was premier. But contrast her decision with Education Minister Adrian Piccoli's pledge on Friday that he would not quit parliament if Nationals leader John Barilaro doesn't include him in the new cabinet. Should Skinner be condemned for putting her desire to keep working in the portfolio she is expert in before the government's best interests? Some of her colleagues are saying just that. That, however, does not factor in the marathon 14-year apprenticeship Skinner served as opposition health spokeswoman. Did she not deserve to see out another two years until the 2019 election as minister? Skinner, like Piccoli, has performed well in the role, but had some gloss knocked off her last year after several high profile health system scandals, making her an easy target for the opposition. This, along with Berejiklian's need to send a message of renewal, likely contributed to the decision to move Skinner out of health. Those who work on the front line of the NSW health system are praising her record as she leaves. However her final action is judged, that would indicate that NSW has just lost an excellent health minister.