There will be other issues surrounding the Tierney report which were not advanced at the time, including the reorganisation of acute hospital services. However, there was also the issue that the appointment of a new hospital consultant required the appointment of a new team, which resulted in the number of junior doctors increasing from more than 2,000 to more than 4,000. Hanly proposes a more complete package involving all the various players, disciplines and professions. It also had to consider another imperative, namely, the working time directive which imposed a discipline on the exercise that was perhaps missing from previous exercises.