Hospital consultant services will be in transition for at least 20 years in the move to create contracts where doctors provide exclusively public healthcare, Minister for Health Mary Harney told the Dáil.
Defending her proposals for tax incentives for the creation of private hospitals on public hospital grounds, Ms Harney said the idea was "to remove private beds from the public hospital system and convert these to public beds for use by public patients".
She added: "I wish to see patients selected into public hospitals on the basis of medical need, not on the basis of whether they have private health insurance."
Fine Gael health spokesman Dr Liam Twomey said: "It does not bode well if consultants are to have public-only contracts, and these private hospitals are to be supported by the HSE".
Ms Harney said: "We will be in transition for some time as the existing consultants' contract has no review clause and is, therefore, a legally binding document for all consultants who have it until they retire".
She wanted to see "a new contract focused on patients, not on whether patients will pay in public hospitals".
There were 2,500 private beds in public hospitals. It was "incredible" that one Dublin hospital only got paid for 20 per cent of the beds although 46 per cent of them were used for private work.
The public hospitals got about €200 million from insurers in 2003, although work valued at €581 million was carried out. "This is not a good return," she said. The initiative would free up 1,000 additional public beds over the next five years.
Labour's health spokeswoman Liz McManus asked if the Minister was being "naive in thinking that by building the hospitals, private patients will automatically go to the private hospitals despite being entitled to go to a public hospital".
Green party spokesman John Gormley referred to consultants Risteard Mulcahy and Maurice Neligan, who said that "public patients are undertreated and private patients are often overtreated because money is involved".
Sinn Féin spokesman Caoimhghín Ó Caoláin said the Minister for Finance was unable to tell the cost to date of tax relief for developers of private hospitals, and the only criteria for qualification was the hospital's capacity.
Ms Harney said every party "supports tax relief for films and other things such as urban renewal which have all been worthy schemes that have achieved fantastic results.
"We do not, however, seem to be capable of supporting, through tax measures, sensible investment in the healthcare system."
