Sir, - In the first of her articles on the health services (October 2nd) Maev-Ann Wren writes: "When the VHI was founded in 1957 the motivation was to provide private income for doctors who had successfully, and with the help of the Catholic Church, fought off decades of politicians efforts at establishing a comprehensive health system."
This statement is not only untrue, but it is also rather insulting to those who, over 30 years ago, gave so much of their time, knowledge and experience to the planning of a national system of health insurance suited to the needs of this country. As the Minister responsible for Health at the time, may I state the facts?
On the implementation of the 1953 Health Act, which followed the ending in 1956 of medical non-participation, the position was that three-quarters of the population were entitled to avail of health services under the Act. These services were, as to medical card-holders, financed entirely by the State and as to others, partly by compulsory insurance under the Social Welfare Acts.
Outside these classes were about half-a-million people who received no benefit from the Act but who nevertheless in tax and rates had to contribute towards the cost of the services provided. Further, it could not be ignored that at that time, as now, the cost of hospitalisation because of a serious illness was so high as often to threaten bankruptcy.
This situation was unjust and it led to my establishing in 1955 an advisory body to consider whether in our circumstances, a system of voluntary health insurance would provide a solution. This body examined all aspects of the problem and eventually reported in May 1956. The result was the passing of the Voluntary Health Insurance Act 1957.
Maev-Ann Wren goes on to say that "VHI and private medicine were heavily subsidised by the State". This again is untrue. In moving the Bill in the Dail, I made it clear that the service planned would not cost the taxpayer a penny. The Bill received the unanimous approval of the Dail.
To enable the VHI Board to be established, an interest-carrying "State" loan of £25,000 was sanctioned, of which only £13,200 was availed of. This was subsequently repaid to the State.
Your contributor also seems to complain that income-tax relief is given in respect of Voluntary Health Insurance contributions. While this may be so it can be equated to relief which is also given to these who have had to meet such expenses not covered by insurance.
Finally, Ms Wren says that the organisation of our health services is unique and unlike those in any other European country. Does this matter? Surely the test must be, does it work? And while a lack of resources may play some part, surely the real problem is the lack of nurses. - Yours, etc.,
Thomas F. O'Higgins, Monkstown Road, Co Dublin.