The singularity of the apparent clash of church and state in 1951 and its easy resolution in 1953 should alert us to the dangers of accepting the perception of events as the reality This paper attempts to explain the complexity of factors that gave rise to the appearance of conflict. The evolution of health policy, the relationship of de Valera and Archbishop McQuaid, the intricate politicking of the first inter-party government, the role of the Knights of St Columbanus, the lobbying of the Private Practitioners’ Group of the Irish Medical Association and the medical profession’s influence with the catholic church and the Irish government — these are some of the factors entangled in the controversy The crisis of 1951, however, provides the touchstone by which one can judge the relevance of any record, and the reader should bear; in mind that the confusion of influences covered here relates ultimately to the illusion of conflict. We must go back to the seminal period, the Emergency — the period of the Second World War — to begin to unravel perception from reality