Reform of procurement in the NSW public health system is a huge, complex and difficult task. Much thought has been given to this reform. An immense amount of planning and preparatory work is required, and is apparent. In our opinion, at this time, the NSW public health system is making only limited progress towards achieving the economies in purchasing that its size and market dominance could deliver. While millions of dollars in savings are potentially available, much needs to be done to realise this. It is critical that all those involved, at all levels, ensure that reform is given priority, and driven through to fruition.