Dr. Alan Barrett:

I do not think any of us is a health expert so we may kick the Senator's question to touch. We can, however, put him in touch with one of our colleagues who knows a lot about it. I will make a couple of points here. When we produced a report on primary health care some of the data difficulties across the two jurisdictions came up very starkly. It turned out to be way more difficult than anticipated. Originally, the idea had been that we wanted to look at access to primary care North and South on the assumption that under an NHS system, there was greater and freer access to primary health care in Northern Ireland, and that might manifest itself in certain positive health outcomes. The project turned out to be much more difficult because the basic data and information were simply not available. In a way, this takes us back to some of the questions that were asked earlier. When one attempts to integrate two health systems the data requirements are enormous. If systems are not talking to one another, even at that stage, a huge amount of work needs to be done to start blending things.

We talk about the two systems as if they are remarkably different. However, one of the points that was brought home to me as we were doing things is that people talk about free at the point of access universal healthcare in Northern Ireland, and not in the South. We have to remember that something like 1.5 or 2 million people in the South have medical cards or GP cards so a huge proportion of people have access similar to that in the North. Sometimes we probably exaggerate some of the differences between the two systems.

The very last thing I will say relates to the premise of Senator Ó Donnghaile's question, which was that in a unified island we will have a single system. Maybe we will not. I am involved in the analysing and researching Ireland, North and South, ARINS, project between the Royal Irish Academy and the University of Notre Dame. This group is giving a lot of thought to a lot of issues. As the Deputy will understand, one of the starting points there relates to what precisely a unified Ireland would look like. They are talking about everything from having Stormont remain in place. I am sure there are countries in the world that are way more federal. There could be a system where there are two systems remaining on the island. There could be a transition period during which we would look to exploit some of the benefits. It goes again to some of the points made by Mr. McGuinness over time. If we think about reunification possibilities, it does not have to be a big bang in the sense that everything is this way one day and then everything is a different way. There can be transitions across economic development, the merging of systems and a whole range of other circumstances. For practical reasons it could take a very long time to blend the North and South health systems.