The last ten years in parallel with the chronic care which the GP is increasingly delivering by using a practice nurse. We were confronted with more data and that you need to record more data and to show your data on performance. The administrative burden was increasing, and the doctors do not believe that it will lead to better patient care it's only for administration. There was really a frustration about the increasing administrative burden. That was one reason for the movement has moved on. In English, it must change. The movement was initiated by a couple of doctors, which have their own practice in Holland. They grouped together and they set it up. It was from bottom-up. They got within a few months support from almost all the GPS in our country. It was a huge, suggestion with a huge effect. There was a conference organized a few months later. The Minister was also invited. She supported the movement. It was quite surprising, she supported the movement. She said, well, we have laws in the Netherlands. I cannot change the law, but I can help you, and you can help me to apply the law better than they do now. We were all owner of the same problem, and then start working group starting with tackling the issues. That have really in effect and we're more confident then, that we were taken seriously. That has a large impact. Other issues were the quality of care, there were concerns about how you monitor quality of care and how what you need to do for practice accreditation, or for relations. That should also be not too much. The third issue of it must change movement was collaboration between the general practitioners. Historically, we tolerate in smaller groups, sometime within the practice, but also between practices in one region or one town. We have agreements, for instance, about when a patient wants to change from one to the other doctor, then we have gentleman's agreements that we discuss this, the reason and to prevent that patient's are shopping from one to the other doctor. The patients want to have a doctor who's doing better care than the other one. That's why we have agreements. But they can conflict with the law, for instance, if you do that, you can also refuse a patient. Well, I'm not a better doctor. That the patient can then think, well, what kind of doctor doing. They limit my options. The patient has freedom to choose a doctor, and the doctor needs to be open for that. But if you have agreements, then it can block the freedom of the patient. There's also a law that prevents the doctors sets limits to the patient. You cannot agree on prices other than has been nationally endorsed. So that can conflict, and that was also an issue for the movement to have more clarity about what's acceptable and what's not acceptable. That was the three issues of it must change. It's still going on. It's really still a success. They have good contacts with our Minister. You can see this in addition to our national organizations, like the Dutch care or general practitioners, that's the association of the obligation. We also have an umbrella organization of care groups, which more cares about organization. Why we are so strong in the Netherlands, that we also have guidelines which are supporting us in decision-making on more than 100 topics, and evidence-based guideline. So we are quite confident that we deliver good care. We also have e-learning materials. We have information for the patient on [inaudible]. We also use the guidelines in education and continuous Professional Education. All the elements in the quality circles are troubled with our organization. That also has the impact that our ministry is very confident with our care, but still we need to comply to the rules and laws. That's why the movement is coming up.