Madam, - I was rather taken aback by the tone and content of Minister for Health Mary Harney's opinion piece (July 28th). Obviously I have a subjective view but I thought her attack on me was just a little over the top. Let me remind readers that my only reference to the Minister in my article was:
"The Government must face up to the reality that the ideologically driven model of private health care provision upon which they embarked under the current Minister for Health Children is no longer sustainable".
What is so objectionable about that as a point of view? Perhaps it is the reference to ideology?
I have no objection to conviction politics per se. The problem is that I believe that in Mary Harney's case she is a conviction politician of the neo-liberal school and that she is wrong.
I think she has had a profound influence in all governments of which she has been a member and that as a result Ireland has embarked upon a policy trajectory that future generations will come to regret.
As to co-location and Social Partnership, the Minister's initiative was never agreed in that forum.
In her article, the Minister calls for respectful dialogue and compromise on the issue. I am all for that although there has not been much evidence of it to date.
Finally, I accept that Mary Harney's motivation is the public interest as she conceives it. However, it will not be much consolation to those affected by her mistaken policies to know that she meant well. - Yours, etc,
DAVID BEGG,
General Secretary,
Irish Congress of Trade Unions,
Parnell Square,
Dublin 1.
Madam, - The Supreme Court's recent decision on community rating presents Government with an unexpected opportunity to make a strategic and radical change of direction in health policy.
Government can create new laws to prop up private healthcare insurers - or it can invest those funds in a high-quality system to properly manage chronic diseases in the community.
The Minister for Health and Children has indicated that Government will take time to find a legislative mechanism to reintroduce community rating.
Such a decision will reinforce a private healthcare industry which is unaccountable, which cherry-picks profitable interventions and which depends on the public health system to provide the fundamentals of care.
The alternative decision is to allow the principle behind the Supreme Court's decision to stand - let the private sector accept its responsibilities as well as its profits.
The needs of older people can best be met, not by encouraging some to buy expensive health insurance - with limited medical value but great hotel accommodation - but by offering all an excellent standard of prevention, early detection and continuing care for illnesses such as diabetes, chronic obstructive pulmonary disease, hypertension, heart disease or psychiatric and psychological illnesses.
For years, Government strategy has inexplicably fostered a mindset among the public in which the State's own services are mistrusted and a voracious private sector is promoted as a model of efficiency, high quality and comprehensive care.
More than half the population now holds private health insurance - why?
The funds used by the State to subsidise this selective care would go a long way towards paying for a quality system for all.
But more importantly, an unequivocal commitment to an effective public health service would restore some confidence and trust.
An opportunity to rethink the fundamentals of health strategy is a valuable and rare gift - Ms Harney and her colleagues in Government should grasp the opportunity to act decisively. - Yours, etc,
Prof GERARD BURY,
UCD School of Medicine,
Belfield,
Dublin 4.