Madam, - While Fintan O'Toole (Opinion, June 12th) may bemoan the emergence of new independent providers in Irish healthcare and the deficits in quality of the US healthcare system, he might also acknowledge the US contribution to global health research and development, which has led to vastly improved health outcomes from a panoply of innovation and specialised intervention.
Ireland has benefited directly from such research, notably in our vastly improved cardiac outcomes of the past decade.
There are many aspects of Irish health provision which one may find objectionable, such as long waiting-times, diminished access, inexplicable service bottlenecks, delays, poor hygiene and a two-tier system which breeds inequity in access.
More capacity from independent providers affords an outlet for total demand to be managed, builds flexibility for improved access and value and exploits the unique difference of the Irish health system. A system which is neither "Boston [ n]or Berlin" provides an opportunity to extract the clinical and financial benefits of a private and public healthcare system working in synergy.
Those who favour an Irish national health service should consider the UK system where patients consistently wait two to three days to see a GP and enjoy the benefits of a moribund public health system frozen by inflexible bureaucracy, poorly aimed investment, and paralysis at secondary care level which was so well highlighted in Sir Gerry Robinson's recent television documentary Can Gerry Robinson Fix the NHS?
I believe the combination of a vibrant and dynamic independent sector working in tandem with the public system is the only remedy if patients are really to occupy centre-stage and achieve their long-heralded entitlement to a safe, equitable quality-based healthcare system. - Yours, etc,
DAVE SHANAHAN, CEO, Charter Medical Group, Smithfield, Dublin 7.