Efforts at effective management at national and regional level were dissipated by the proliferation of organisations and the absence of management capabilities on boards. The value for money audit did not make a strong recommendation about health boards and agencies but the issue of what to do about them was highlighted in An Agreed Programme for Government as a matter of urgency. The programme states: "We will seek the completion of the report on health agencies and management structures by the end of 2002 and will move forward on the principle of removing unnecessary overlap of functions and minimising delays in implementing service improvements." The report by Prospectus Management Consultants is nearing completion and I understand its recommendations are likely to come before Government soon. It is vital that this report and others nearing completion in the areas of financial accountability and medical manpower are far-reaching and courageous in their conclusions.