One must get those responsible for managing the health services to accept they are the ones who are accountable. Anybody working in a health board will tell you that when a decision is taken somewhere in its amorphous bureaucracy you can be certain that you will not know who took it. It is not a revolutionary change that every decision taken by the management of something as large and complex as a health service should identify the individual taking responsibility and the circumstances under which that decision was taken. The result of the current mode of operation is perpetual frustration with nobody knowing why some decisions were taken and others were not, while nobody knows who was responsible.