To achieve good and responsible medical care, not only is it necessary to legislate to control training, the institutes responsible for training, and continuing medical education, but it is also necessary to document ratings of mortality and morbidity as well as measures of workload for those providing care. We, as an Association for Paediatric Cardiology, must be more active in this process, and in politics, so as to convince the patients and the authorities that these processes are necessary, and to obtain the financial requirements to permit them to be achieved. Much has still to be done.