An extra 1,000 acute hospital beds will be provided for public patients in major hospitals across the State over the next five years under an initiative announced yesterday by Minister for Health Mary Harney.
The beds are currently set aside for private patients in public hospitals, but are to be clawed back by transferring private patients who use them to new private hospitals which will be built by investors on the sites of public hospitals.
Ms Harney said the sites would be leased or sold at commercial rates to private developers.This was the fastest and most economical way of meeting the need for extra hospital beds.
It costs up to €500,000 to provide a new hospital bed, and about €300,000 a year to staff and run one. Private developers will be bearing this cost under the plan.
And while public hospitals will lose income they get from private patients under the plan - currently they receive €220 million a year from the 2,500 private beds in public hospitals - it is felt the benefit of gaining extra beds in public hospitals will be sufficient compensation.
The benefits for private developers will be tax breaks and being on the site of public hospitals which could buy services from them.
Ms Harney said consultants, some of whom in future may be asked to take on public work only, would save time travelling between public and private hospitals.
Expressions of interest from developers seeking to build the new facilities will now be sought by the Health Service Executive (HSE). It has been told any proposals from investors will have to meet a range of criteria, and that it should only accept proposals for the development of private facilities on public hospital sites "where the consultants accept that there would be no question of them having to be compensated for the transfer of their private beds to the private facility" and where consultants agreed to work in teams.
Ms Harney did not say where the new private facilities would be built but given that private hospitals require 80-plus beds if they are to be viable, the sites of public hospitals with most private beds are likely to be chosen.
These include Tallaght, St James's and Beaumont hospitals in Dublin; the Mid Western Regional Hospital in Limerick; Our Lady of Lourdes Hospital, Drogheda; Cork University Hospital; and University College Hospital, Galway.
Ms Harney stressed that the HSE "will not support initiatives in a region where there is adequate private capacity at the moment".
An extra 3,000 beds were promised in the national health strategy in 2001 and to date just 780 are in place, according to Department of Health figures. The Irish Hospital Consultants' Association (IHCA) claims just 419 of them are in place.
Ms Harney refused to say yesterday if the target of providing 3,000 extra beds by 2011 would be met.
Meanwhile she said private health insurance companies at present are charged just 60 per cent of the actual cost of acute beds in public hospitals, and she plans to move to charging them the full economic cost. This is likely to push up insurance premiums further.
The president of the Irish Medical Organisation, Dr Asam Ishtiaq, said he welcomed any initiative to increase bed capacity in the public hospital system but the plan appeared to be overly reliant on the private sector. "Our concerns are that development of for-profit private medicine in Ireland may not be in the best interests of the long-term future of the health service."
Donal Duffy, assistant general secretary of the IHCA, said while an extra 1,000 beds were welcome, they were far short of what was needed at a time when the population was growing.
The Irish Nurses' Organisation also welcomed the plans for extra beds but questioned how they would be staffed.
Labour's health spokeswoman Liz McManus said Ms Harney's plan had "a touch of desperation about it". The Government had abandoned its plan to provide 3,000 additional hospital beds, and was trying to use private hospitals "as some kind of panacea to the ills that beset the health service that they have blatantly failed to resolve".