The present system of determining the mix of public and private healthcare was driving patients into private care, the Dublin Economic Workshop was told in Kenmare at the weekend.
Allowing hospitals and consultants to decide the balance was inimical to the proper functioning of the public health system because it created incentives for both of them to create waiting lists, Mr Joe Durkan of the department of economics in UCD told the workshop.
The arrangements governing the allocation of resources between private and public care in public hospitals needed substantial change, he said.
Mr Durkan also criticised the indicative drug targeting scheme which was designed, against a background of very significant rises in the cost of prescribing drugs, to establish prescribing targets for each GP in money terms. He said it was not obvious that savings in one area resulted in overall savings for the healthcare system.
There was some evidence from the United States that cost savings in drugs could lead to a reduced quality of care and additional costs in the healthcare system as a whole, he add ed.
However, Mr John Armstrong, health economist and actuarial executive with VHI Healthcare, said the current public/private mix in terms of the delivery of services in the healthcare system should remain intact as it has provided a relatively efficient Irish healthcare system.
But the balance between the two might need to change, with greater involvement for the private sector in the financing and delivery of services, he said. The forthcoming Government Health Strategy might provide an opportunity for this to happen, he added.
Mr Armstrong said the private sector could provide additional efficiencies and funding to the system so that scarce public resources could be spent more effectively.
Public-private joint ventures were a means whereby capital infrastructure in the health area could be developed and maintained with private assistance.
Mr Martin O'Rourke of BUPA said there was a need to reduce administration in the health service and the number of health boards.