A proposal to have 11,000 public patients a year treated in private hospitals is expected to be considered by a Cabinet committee in the next week.
Senior civil servants in the Departments of Finance, Health and Children and in the Office of the Tβnaiste have met representatives of the private hospitals to discuss the proposal.
The proposal echoes a plan by the Progressive Democrats to offer private healthcare to people who have spent more than three months on public waiting lists.
The Independent Hospital Association of Ireland (IHAI), which represents the vast majority of private hospitals, has told Ministers they could treat a further 5,000 to 7,000 public patients a year if they got tax incentives to enable them to expand.
Of the State's 12,500 beds, private hospitals account for 2,500.
The Cabinet committee is to meet to consider the forthcoming national health strategy. The proposal which would see private hospitals treat 11,000 of the 27,000 people on the waiting lists is expected to be on the agenda. Private hospitals would be used while the capacity of the public hospitals was being built up.
Most procedures in private hospitals are carried out by consultants who work for public hospitals but are allowed to work in private hospitals as well.
The IHAI proposes regional health boards be authorised to make agreements with its members on numbers of patients to be treated privately and how much should be paid for this treatment.
It is likely the private hospitals would press for three-year contracts from health boards. This is a condition which its chairman Dr Con Power says would have to be met to enable them to expand to treat more patients.
In a letter to the Department of Finance, the Office of the Tβnaiste and the Department of Health and Children, the association argues it can treat patients waiting for a broad range of procedures. These include cardiac surgery, ENT (ear, nose and throat), ophthalmology, urology, gynaecology, vascular surgery, orthopaedics and general surgery.
In some areas the collaboration is between a private hospital and a publicly funded hospital on the same site, it says. "For example, collaboration between St Vincent's Private Hospital and St Vincent's University Hospital, and collaboration between the Mater Private Hospital and the Mater Misercordiae Hospital."
Apart from doing surgery, the private hospitals could provide "step-down facilities and facilities for convalescence, the use of which by the public sector can alleviate pressure on acute hospital beds."
The private sector could train more health professionals, it says, if given recognition by educational authorities.
About 37 per cent of all the State's public consultants are allowed in their contracts to work also in private hospitals. Almost all the remainder are entitled to do both public and private work in public hospitals. A small minority of consultants - about 150 - work in private hospitals alone.
Consultants' pay for their public work is weighted so that those who have least opportunity for private work are paid the most. These are in the Midland Health Board, Western Health Board and North Western Health Board regions.
The lowest rate of pay for public work goes to consultants in Dublin, Kildare and Wicklow because they have greater opportunities for private work.
The National Health Strategy will go to the full Cabinet after it is agreed by the Cabinet committee.
The latest expected publication date for the strategy is around the second week in November though expected publication dates in September and October passed without its appearance.