As already stated 17 specialties – anaesthesia, diagnostic radiology, general medicine, general surgery, morbid anatomy and histopathology, neurological surgery, neurology, obstetrics and gynaecology, ophthalmology, orthopaedic surgery, otolaryngology, paediatrics, plastic surgery, psychiatry, radiotherapy, respiratory medicine and urology – are recognised in all states. At present, however, if a specialty is recognised in two states or more it is still recognised as a specialty. For example, cardiology is recognised in 11 states including Ireland; child and adolescent psychiatry is also recognised in 11 states including Ireland; microbiology-bacteriology is recognised in 12 states including Ireland; occupational medicine is recognised in 14 states including Ireland; and thoracic surgery is also recognised in 14 states including Ireland. However, accident and emergency medicine is recognised in only two states – Ireland and the United Kingdom. There is nothing to say that other countries will not proceed to recognise this area of medicine as a specialty. That is what one would expect and it is what everyone in the medical profession in the European Union has been working towards in the past 30 years. It is, therefore, extraordinarily difficult to understand the course of action taken by the Commission.