The juntas are not disruptors, they have the capacity to be, but vested interests are too strong. The 1990 reforms to decentralise the CCSS architecture, primary care reforms to create EBAIS and creation of a unified health and social care electronic patient record (EDUS, as discussed earlier), demonstrate that the CCSS is able to reform. In the hospital sector, however, and more critically, in the broader issues of transparency and accountability, the system has made little or no progress.