Looking back, the first thing that struck Dr Kevin Harrington when he began working within Britain's National Health Service (NHS) was how "so much could be done for so little."
"Now we say that so little is done for so much," he says, after nearly 20 years of practising in the UK where he is now a consultant and senior lecturer in obstetrics and gynaecology in London.
Recalling his first perceptions of the NHS while working in Hammersmith after emigrating from Dublin, where he trained at the College of Surgeons, he remembers being struck almost immediately at its quality and scale. "The fact is that there was this free service for everyone, and you could see this socialist dream which was quite amazing," he says. "It has fallen into some decline, but people forget that if you wanted to see a GP you just made an appointment and you went down to them."
Despite changes in recent years, he still believes the NHS compares favourably with the Irish health service, adding: "The first thing is the level of investment is far greater. A lot of people complain about the NHS, but they are often getting a much better level of service then they would have in private care at home [ in Ireland].
"But the perception in Ireland is different. When you are in Ireland the perception is that you are getting a state-of-the-art service. The reality is different when you compare it to NHS, even though the facilities [ in the UK] don't compare with the likes of Germany or France.
"What has happened here is that they have put a lot of money in but it's not tied to productivity. In the last six to seven years they have put a lot of money in and have not got a lot back. That is one of the lessons for Ireland. You have to make sure that there is accountability for it. A lot of it has been swallowed up and productivity has gone down. In terms of investment there is a lesson to be learned."
He also advises against rushing headlong towards emulating Britain's embrace of Private Finance Initiatives (PFIs). "They do take the pressure off the public purse, but it is considered a very expensive way of doing it because when you look at the total cost, it's considerably more than if it was state funded," he says.
"What has been exposed here is that what you want to try to do is not have political involvement. People are so worried about day-to-day politics.
"If the Irish system allowed private funding but spent the money on the greatest need, and not on the greatest political priority, then that would be great, although in a country the size of Ireland I can't see that happening because of the proportional representation electoral system."
Criticisms aside, Harrington still points to aspects of practising medicine in Britain which continue to attract Irish-trained doctors, albeit in smaller numbers than in the past. "You get a diversity of work here that is more challenging," he says, pointing to some of the issues encountered by medical practitioners working in major urban centres. "For example, we have a multi-racial population with all the sorts of complications that go with that, so there is experience of a much wider range of diseases, some virtually non-existent in Ireland."
He estimates that there are at least 5,000 Irish-trained doctors practising in the UK and he recently founded a new body, the Irish Medical Society (www.irishmedicalsociety.org), describing it as an "informal network" for their interests. "We are one of the largest groups of doctors but we didn't have a group where we could come together. We will focus to act as a support," he adds. "All through the 1950s and 1960s, Ireland produced far more doctors than it could employ and England was the first place many went if they left. That seems to have slowed down."