Madam, - Dr Orla Hardiman (July 3rd) eloquently opens up an important debate on public-private partnership in the health service, but is off the mark when she suggests public hospital consultants "seek to capitalise on a situation of uncertainty and low morale" by engaging with for-profit hospitals.
In my own speciality, neurosurgery, the standard of equipment in theatres is rapidly dropping to Third World levels despite a strenuous and well publicised drive on our part to improve the situation.
We are still awaiting the release of a Comhairle na nOspidéal report, completed months ago, that supposedly sets out Government's plans for the future of the speciality and we are still the only country in the western world that does not offer surgery for Parkinson's disease.
If my colleagues and I simply wait for neurosurgical facilities to improve in the public sector, it will never happen and more and more patients, like those with Parkinson's Disease, will seek treatment abroad.
What are we to do? Resign and go to work in a private facility that offers the very best of neurosurgical equipment but be restricted to treating private patients?
Recent interview experience tells us that, at least in the short to medium term, there would be very few neurosurgeons out there to fill our shoes in Beaumont.
Having trained in the golden era of the UK National Health Service when patients received the same high standard of care regardless of status, there is nothing I would like more than to be able to provide the same from Beaumont Hospital. I'm sure even Dr Hardiman realises this will never happen.
Meanwhile we, who as consultants must bear ultimate responsibility for our patients, are expected to sit back and watch the public neurosurgical facilities in Ireland slide to levels that will shortly become medicolegally indefensible.
Far from being a Faustian pact, working with private hospitals looks like the only way the highest standards of neurosurgery will be attained for all patients. - Yours, etc,
STEVEN YOUNG FRCS, Consultant Neurosurgeon, Department of Neurosurgery, Beaumont Hospital, Dublin 9.