The chief executive officer of the Health Service Executive has said he is happy for the private sector to do what it wants on public hospital sites they are given for co-located hospitals once it pays the HSE the full cost of those sites.
Prof Brendan Drumm said: "As long as we get paid for the sites, and we will get paid the full economic rate for the sites, then we are perfectly happy for the private sector to do what it wishes on co-located sites."
Prof Drumm was speaking to the media yesterday after addressing a healthcare conference at Croke Park.
At the conference, Prof Dale Tussing, the American economist who has been studying the Irish healthcare system for many years, called for the co-location project to be stopped.
Asked if he agreed with this view, Prof Drumm said: "I see co-location as being a competitor for the HSE. It wouldn't be within my remit to say that it should stop because I think that would be a very easy thing for me to say . . . everybody would say that they don't want competition.
"I think we should be glad of competition, and we'll stand up and we'll actually be counted in terms of saying we can provide a service every bit as good as what can be provided on a co-located site."
He added: "The co-location project, in terms of running the health services in Ireland, is not a significant issue for me. My job is to run the public health service. . . "We were asked to facilitate Government in terms of handing over sites and making sure that we got proper economic payment for them, but once that's facilitated then it really has nothing to do with us going forward."
Prof Drumm told delegates he believed the health system was not in crisis. While changes were required in a number of areas, this did not mean that there was a crisis. There needed to be improved co-ordination of health services at all levels, as well as improvements in A&E and in primary care.
He rejected again the suggestion that more acute hospital beds were required.
Prof Drumm said nobody had provided any evidence "except one study that was done many years ago" to support the provision of more beds. A recent review of how hospital beds are used had found that 40 per cent of patients in them on any given day did not need to be there.
"Building more beds when 40 per cent of them are being used inappropriately is hardly a solution that anybody proposes realistically to solve our healthcare problems," he said.
Prof Tussing said that more beds alone would be of limited help. "More beds without structural reform may truly be a black hole for resources," he said.
He also said that primary care needed to be improved to relieve pressure on hospitals. But the HSE was busy creating primary care teams without primary care centres promised in 2001. The HSE had told him the centres would "commence planning stage" this year, which meant they were some way off, he added.
Prof Drumm responded by saying that infrastructure was important, but it was not the critical issue.
Prof Tussing also called for a single waiting list for all patients, public and private, managed by someone with no economic interest in the order in which patients were treated.