Kate O'Connell (Dublin Bay South, Fine Gael)
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I worked in the NHS in 2003 or 2004. Around that time, if my memory serves me correctly, there was a sort of realignment of the NHS, because the costs were getting out of control when it came to pensions, and there was a huge renegotiation of contracts. I was a junior at the time and I was not really thinking about a pension at that stage. My question is this. Has Professor Pollock any suggestions as to how we can anticipate such overruns and how we might manage those if we are looking at a universal health care model in this country?

I may not be right but my experience in the NHS was that there was a very good basic level of care, which was quite universal, and an extensive menu of services but that higher levels of treatment were not necessarily, in my experience, as good as perhaps we have here. There were huge restrictions. One thing that struck me when I returned to Ireland was that in Ireland, one got whatever treatment one required. Depending on the type of cancer one had, there seemed to be fewer restrictions. In the UK, there was huge input by the pharmacoeconomics departments into working out the cost-benefit of drugs. On the ground what that meant was that people did not get the same level of treatment that people in Ireland were getting for some complex illnesses. What is Professor Pollock's experience in that regard?

My understanding is that GPs in the NHS must reach specific targets when it comes to certain conditions. For example, they must do X amount of smears in a month and X amount of interventions with people with diabetes. I happen to have a family member who is a GP in London. From chatting about it, sometimes, in order to reach those targets for those specific and very important health measures, day-to-day bread and butter stuff like children with tonsillitis and other bits and bobs tend to get pushed to the side because GPs are so focused on meeting their targets for certain things within the basket of treatments that their surgery is to deliver. What are Professor Pollock's views on that and how it has trickled down and affected people's lives?

The prescription service in the NHS - I think the forms were called FP10s but the name may have changed - was free at the point of delivery. There were no prescription charges for pregnant women, army veterans or students as well as those who satisfied a means test. My experience as a pharmacist in Ireland is that sometimes we need a small barrier - not a massive one - at the point of delivery, so that people appreciate things and there is less waste. Does Professor Pollock agree?

I think that is it. Will Professor Pollock address the pitfalls in the GP contract, the levels of care comparatively between the two countries, that there are no barriers to access and the pressures unrestricted access to certain services put on a system?