Let us look at the manner of achieving the correct balance between medical and administrative staff. For instance, in the accident and emergence department of one Dublin hospital there had been a manager to co-ordinate everything on a particular shift. This was necessary and maximised resources and was appropriate. When another person was added to that shift, it was an assistant manager, not someone who would increase the level of care available. This is symptomatic of what is happening in many areas of the health service.