There is no evidence to show that consultants who carry out private work in public hospitals are neglecting their public patients, Dr Peter Kelly of the Irish Hospital Consultants' Association told the Colmcille Winter School on Saturday.
Dr Kelly, a consultant histopathologist in the Mater Hospital in Dublin, said the Department of Health had conceded that "the vast majority of consultants comfortably satisfy or exceed their contract requirements" of 33 hours' public work per week.
Accusing some of taking a "simplistic" approach in their analysis of the health service, he said "a constellation of problems cannot be addressed by looking at a single factor in isolation".
Comparing the public and private sectors was like "comparing apples and oranges".
The public sector was inflexible, structurally inefficient and had waiting lists for elective procedures of up to five years. Because Accident and Emergency accounted for more than 80 per cent of admissions, there were periods when other admissions were not possible.
In the private sector, by contrast, admissions could be planned and there was flexibility and minimum waiting times.
He said that waiting times of years were unacceptable in an advanced, rich society, but in the current system were unavoidable. The quality of care was good when people actually got it.
The IHCA had over many years pointed out the inequality of the system and demanded the resources to balance it, Dr Kelly said.
The main problem was lack of resources and, although improving, these were still not meeting demands. There was a need to rationalise hospital infrastructure, the nursing shortage was at crisis level, and the intake to medical schools also had to be considered. About 700 more consultants were needed.
Dr Kelly said the solution was not just to spend more but to make the infrastructure more efficient. Doctors' time was being wasted by a lack of support and inappropriate use of resources.
On a Fine Gael and Labour proposal to make everybody a private patient, he said he would not object to it in principle but would like to see how it worked out.
Dr Kelly said there was "a gulf emerging between GPs and hospital consultants" and the relationship needed to be examined.