The full development of information and communication technology capability is identified as a prerequisite to improving monitoring and evaluation of services, improved health impact assessment, and, in turn, better value for money. Report after report has identified this as a major system deficiency. There is a need for up-front support of structural reform of the nature being contemplated. A national reform programme will result from the current proposals and that will also require investment. We must continue to invest in the system if we are to keep pace with the changes and at the same time deliver the potential yield from the radical restructuring of the system.