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Accepting recent proposals to supporting dependable e-health enterprise systems via the adoption of emerging autonomic grid computing and services-oriented architecture (SOA); this paper presents the motivations for a novel semantics/knowledge plane for a service-oriented e-health middleware and applications. The paper starts by a detailed description of a developed sensor and actuator framework and overlay. This is followed by, and illustrated using a remote healthcare monitoring scenario. A case-study of pregnancy monitoring is used to illustrate the design and usability of such a grid overlay. Finally, the paper concludes with general remarks and a statement of further work