A chara, – Ray Leonard's conclusion (Letters, April 12th) that "based on the Lancet's assessment, the HSE, for all its flaws and for all we complain about it, is clearly doing something right" is not supported by the facts. The report published by the Lancet (July 15th, 2017) was prepared by the "GBD 2015 Healthcare Access and Quality Collaborators" and presented an "Index based on mortality from causes amenable to personal health care" in 195 countries. The difference between Ireland (88 points) and the UK (85 points) is not material.
However, as Britain and Northern Ireland have a universal health care system, free at the point of use, it is not unreasonable to assume that the results are a good proxy for the performance of the NHS. However, the results for Ireland do not measure the performance of the HSE, but the performance of our two-tier health system. It would be more reasonable to assume that our private healthcare system delivers care on a par with countries such as Sweden, Norway and Australia (90 points), while the HSE delivers care somewhat below the standard provided by the NHS. This is why the Irish public health system must be brought up to the standard of the private healthcare system and made available to everyone, without discrimination, free at the point of use. Progress on this objective is a prerequisite to unity of north and south. – Yours, etc,
JOHN HEARN,
Malahide,
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Co Dublin.