A united Ireland needs a national health service which is free at the point of access, Sinn Féin leader Mary Lou McDonald has suggested.
Ms McDonald said the conversation about a united Ireland should start with the health services in both jurisdictions which are subjects of review – the Bengoa process in the North and Sláintecare down South.
She said any conversation about an Irish NHS cannot be achieved without "political seriousness" and a willingness to "knuckle down" and create an integrated health service.
Health is the issue that is raised the most when it comes to discussions about a united Ireland, “beyond flags and emblems”, she told the Ireland’s Future conference in the Mansion House, Dublin.
“The smart money would join those together and create a single-tier universal health service for people across the island,” she added.
“The conversation around healthcare has to include third-level institutions of education. We have to figure out how we will produce enough GPs to ensure that we don’t endure a shortage and how do we hold on to our nurses and midwives.”
Fine Gael TD Neale Richmond said the Republic's health service scores well internationally and that it ought to be possible to combine the best from both health systems.
He said any all-Ireland health service should be free at the point of entry as a matter of principle, but there could still be room for access to private health care.
Mr Richmond said the present British government is capable of calling a Border poll without consultation with the Irish Government. "We are dealing with an utterly reckless and untrustworthy British government that could at any stage call a Border poll or a Scottish independence referendum without due consideration. You cannot rely on the British government for anything."
Mr Richmond said “now is the time” to talk about a united Ireland because “Brexit has changed everything. I fundamentally believe in a united Ireland. I always have done, but I am now convinced that we will see a united Ireland in my lifetime . . . we are going to be voting on this in a Border poll a lot sooner than we think.
“The chaos that has ensured after the Brexit referendum has led us directly to the point where we are prepared to sit in these rooms and put across a vision for a united Ireland.”
Mr Richmond added that being in favour of a united Ireland should not be an “incendiary opinion” and should never be seen as offensive to unionists.
Fianna Fáil TD Jim O'Callaghan said it ought it to be recognised that Sláintecare is not " a million miles away" from the NHS.
He suggested health economists should prepare a paper to state what a health service for a united Ireland would look like.
“Politicians are not going to be able to identify that now. That is why the work will have to be done in health or the economy. A huge amount of work will have to be done,” he said.
For that reason a citizens assembly on unification would be premature until the preparatory work is done across many different fields, he added.
He described the pursuit of Irish unification as a “perfectly legitimate political objective” and there is nothing “sinister or subversive about it”.
He has been surprised at the level of interest from unionists about a united Ireland. Three loyalists came down to Dublin and met him in Merrion Square. "They want to talk about it," he said. When he appeared on television with Ulster Unionist leader Doug Beattie, he spoke about a new constitution for Ireland.
“He put me in my place and he said, ‘show it to me’. It is hard for unionists to engage at this stage unless the preparatory work is done.”
Unity beyond emotion
It is also a legitimate aspiration to oppose a united Ireland, said Mr O’Callaghan. “But we do need to engage with the opposition because if we don’t engage with it, we are really revealing that we are not comfortable with the strength of the argument that we are making.”
He said emotion is not enough of a reason to vote for a united Ireland. “The reason to vote for it is because it would transform the island and create a new country in which there would be greater opportunities for people who are living in both jurisdictions. We would create a stronger country with much more influence across the world.”
Professor John Doyle of the Dublin City University Institute for International Conflict Resolution and Reconstruction said the £10 billion (€11.7 billion) subvention to Northern Ireland "does not matter" and most of it is irrelevant to a united Ireland.
For instance Northern Ireland contributes £1.2 billion to UK defence, greater than the whole defence budget for the Republic of Ireland.
The real issue is why the Northern economy is so weak, he added. Foreign direct investment and tourism are much lower than in the South. If the Northern Ireland economy was brought up to the level of the economy in the Republic, there would be no need for an economic subvention.
Mr O'Callaghan added that Dublin is too dominant economically and Belfast would be a good counterbalance in a united Ireland.
