There have been various estimates by a number of media and international organisations of the world’s largest employers and there is some debate as to the exact ranking of the national health service. In 2004, the Department estimated that the NHS is the third largest public employer in the world, behind the Indian Railways and the United States Department of Defence. Although there may be some debate as to the exact ranking of the NHS in terms of its comparative size as an employer, what is not in any doubt is that the NHS is one of the largest employing organisations in the world today.