The Ministry of Health and Long-Term Care (MOHLTC) and the hospitals of Ontario have for some time agreed that there has been little clarity as to their respective expectations in accounting to each other for their responsibilities in the delivery of healthcare. Bill 8, introduced in the Ontario Legislature in November 2003, provides the vehicle the government proposes to use to introduce formal accountability processes for hospitals. One major area of disagreement between the Ministry and the OHA concerns Sections 26 and 27, which would permit the Minister to intervene directly with a hospital's CEO. The authors believe that the Minister can exercise effective operational accountability without bypassing the hospital board, and thus avoid clouding accountability.