In my opinion, however, the mechanism suggested in the Brennan report is still too cumbersome. It would take us back to the multi-layered system where bodies report to other bodies which, in turn, report to the Department. The suggestion regarding the accountability of those people with responsibility for expenditure is to be welcomed. The targeting of resources for patients in the most cost-effective way and accountability for those resources is the only way to obtain value for money in the system. The report concludes that the arrangements that allow consultants to combine public and private commitments are unsatisfactory. This is one area of which most people will be aware and it has to be tackled. As Senator Norris pointed out, there is also the issue of medical insurance, which is costing the State €50 million per year.