The Prospectus report states that we need "A health system that responds more effectively to the expectations of its stakeholders and achieves a much greater impact to the benefit of the consumer" and that we need to "build on the existing talents and knowledge of staff." I welcome the four major reforms proposed in the report, namely, a single health service executive, the delivery of value for money and management of ongoing change, simpler governance and greater level of accountability and a reduction in the number of agencies and the reports required from them. These proposals pose a huge challenge for service providers, legislators and consumers.