International evidence is that technically challenging surgery, for example, can best be supported if it is concentrated in a relatively small number of centres. This is a message that is evidenced based and needs to be directed and pursued at a number of levels in our society. It must be understood that having a service is no longer sufficient; it must be a service organised in such a way that it is capable of delivering quality in line with international standards and practice. We must face the reality that we cannot continue to expect to be able to deliver the highest quality of cancer services across over 30 acute hospitals. Perhaps I am being somewhat cruel on the Seanad in saying so because it is in the Lower House that this particular issue comes to the fore even more.