Madam, - When Eileen Malone states that consultants earn their merit and proficiencies at so-called "centres of excellence in the UK, North America and Australia" (June 12th), she indirectly identifies one of the problems of the Irish healthcare system - the continued inheritance of inefficient features and practices from the Anglophone countries, which historically share a common medical base.
For example, the Irish health system is still based on the archaic UK model of the family GP living among his patients and attending to them in his surgery or in their homes. Both health systems are also similarly "matronly" at ward level and resist any departure from old-fashioned ways of doing things, even if white papers recommend improvements.
I believe that if Irish doctors were to broaden their destination horizons for their "years of exile" beyond the Anglophone "centres of excellence" to include the clinically advanced Nordic countries, they would experience efficient community healthcare systems, whereby towns and even villages have a health centre that includes GPs, district nurses, a laboratory for simple tests, physical therapists and, in some cases, pre- and post-natal clinics.
When Irish consultants return from Anglophone or developing countries to join what Ms Malone calls "a health service in chaos", they unfortunately do not possess the new experiences and fresh ideas that could be gained in countries such as as Denmark, Sweden or Finland and that could help to break the cycle of chaos.
More and more Scandinavian nurses are working in Irish and British hospitals; perhaps Irish consultants should also consider exchange programmes with the Nordic countries. - Yours, etc.
NIALL O'DONOGHUE,
Narva,
Finland.