It has to be acknowledged that the present structures in the health system evolved from a model developed over 30 years ago. During that time the size, range of functions and complexity of managing the system have all grown dramatically. There have been significant enhancements to the original health board model through the Health Acts 1996 and 1999 as well as considerable changes to the internal structures of the Department of Health and Children and the health boards. A number of new advisory and executive bodies have also been established in recent years.