The problems identified by Parliamentary Secretary of Health, Mr. Joseph Hamilton a few weeks ago in relation to personnel and materials management are only symptoms of a system that was recognised to be in need of “major surgery” over a decade ago. Notwithstanding the now legally corporatized Georgetown Public Hospital Corporation (GPHC), essentially the old centralised system in which the Ministry of Health is responsible for setting goals, implementing them and then monitoring itself is still very much alive. This kind of incestuous relationship