Compulsory health insurance would reduce waiting lists and get rid of inequalities in the healthcare system, Mr Joe Durkan of UCD told the conference.

He said the recent White Paper has missed the point. "A compulsory scheme where everyone is required to have health insurance would result in a wider choice for patients and reduced waiting lists," he said. Compulsory insurance would also remove Government from the day-to-day running of hospitals so it could concentrate on its regulatory role.

The contributions could be income related as in Germany or a flat rate with subsidies or transfers for those on low incomes. Everyone would thus be able to afford it and it would eliminate the inequality which exists today between public and private patients.

He added that because the system would be insurance financed, tax rates could be reduced. Importantly, it would also mean that patients would be buying services rather than being given them. This would fundamentally alter the relationship between patient and hospital. He also said that for the hospital or service providers, life would become more difficult as they would be forced to compete for patients, forcing efficiencies and improved service.

At present, according to Mr Durkan, there is an incentive for consultants to create waiting lists for treatment in the expectation that many will have insurance cover and will be able to queue jump. There is also an incentive for hospitals to increase the number or of private beds even though there is a public waiting list. Compulsory insurance would eliminate these, he added.