Health system and unification

Sir, – Fintan O'Toole writes about the wild inefficiency and irrationality of our health system organised on the principle of fear ("Skipping the vaccine queue isn't a breach of the health system, it's the system", Opinion & Analysis, March 30th).

The UK and other European states appear to run rational and efficient public health systems in which their citizens appear to have great confidence and great pride.

In our renewed and growing engagements with all the people who call this island home about the idea of a unified state at some future date, may not such future prospect offer our best hope for a rational, efficient public health system in which all may be proud and confident?

Is an offer to build such a system together from the ground up not a key that could unlock barriers to engagement with those who are perhaps most resistant?

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Are we not ready to consider relinquishing our system of access based on affordability and wealth for a national system based entirely on medical need, in the interest of achieving a unified state to which so many on this island appear to aspire, and in our shared interest in having, once and for all, the best healthcare system that we in all our shared wit, creativity, ambition, resourcefulness and caring are humanly capable of providing? – Yours, etc,

WILLIAM AYLMER,

Brittas,

Dublin 24.