41.  A number of groups offer their services free of charge.

42.  A package of accelerations, improved peak-hour services and upgrading of the Master Cutler to Pullman status has generated new business.

43.  A pay-per-view service exists for those who do not have direct access to electronic journal articles via subscriptions.

44.  A possible future is that regions will pass away and districts amalgamate to make contracts for more specialist services - tertiary care.

45.  A private car service is available from the airport.

46.  A second problem with traditional cost accounting systems was that they misled managers about the true cost of products and services.

47.  A separate issue related to quality of care is the range of services provided.