Harney and hospital co-location

Madam, - The recent Supreme Court decision regarding private healthcare in Ireland has again raised uncertainty regarding the proposed co-located hospitals.

The contributions by Fintan O'Toole and David Begg in The Irish Times have forcefully outlined the case against the continued pursuit of this policy.

The rebuttal in today's Irish Times (July 24th) by Michael Cullen, property developer, and Ciarán Cannon, leader of the remainder of the Progressive Democrats, both choose to ignore the obvious - that the current policy will increase the overall costs of health insurance, will consolidate the existing two-tier system, and will diminish the quality of clinical care in both the public and private sectors.

A case of vested interests? - Yours, etc,

Prof ORLA HARDIMAN BSc, MD, FRCPI, FAAN, Consultant Neurologist, Whitebeam Road, Clonskeagh, Dublin 14.

Madam, - Co-location has one distinct advantage which does not appear to have occurred to Fintan O'Toole (July 22nd), or many other Irish liberals, which I would like to highlight.

In circumstances where the Irish public change the habit of a lifetime and actually vote for a government committed to prioritising the adoption a universal public health system, it would be very useful indeed to have all the necessary physical infrastructure constructed in the correct places.

Given their cost and longevity, it is important to distinguish between the best place to build part of an integrated hospital system and the best way to fund its construction.

The co-location funding process we are now embarked on could be regarded as a temporary "toll system" needed to comply with current ideological constraints on the provision of much-needed public infrastructure.

Previous hospital buildings in this country were funded by gambling to deal with similar, now-defunct, ideological constraints.

History shows us how quickly ideology can change in response to public demand, as it did in Britain in 1945, or Cuba in 1959.

In a liberal democracy like Ireland, it really just depends on how insistent the public become. Focusing on the wrong target is unlikely to get the necessary infrastructure built in the most beneficial location or in the shortest possible time.

Nor is it likely to educate the public to their power in the matter of its future ownership, should it fail to operate in their interests. - Yours, etc,

SIMON McGUINNESS, Co-ordinator, Cuba Support Group Ireland, Merrion Square, Dublin 2.

© 2008 The Irish Times

This article appears in the print edition of the Irish Times