The Vice-President (Mr S. Creedon, F.I.A.): This evening we have an unusual, but very welcome, and excellent, paper from Mrs Joanne Buckle, who is going to introduce the key concepts for the paper to us.

Mrs J. L. Buckle, F.I.A.: This topic is close to my heart and I am not going to spend a lot of time talking about the paper per se. What I want to do is spend some time talking about some of the key concepts in the paper, and also to try to steer the discussion in a way that will reflect the differences between the approaches that health economists take to these kinds of questions and the approach that actuaries take, and how those two approaches can be reconciled.

I should explain a little bit about my background and about the background to this paper. I originally wrote this paper as part of my health economics postgraduate dissertation, so it was very health-economics focused. I was marked down for introducing too many actuarial concepts. The academic health economists were not very happy with my focus on return on investment and lack of focus on quality adjusted life years. And that was part of an eye-opening experience of doing my health economics postgraduate course.