Some 50,000 tests carried out on patients every year at Dublin's Beaumont Hospital could probably be carried out at a local post office, the chief executive of the Health Service Executive Prof Brendan Drumm said yesterday.
Referring to the need to transfer more services from hospitals to the community, Prof Drumm said hospitals were for acute and complicated work and that should be all.
But there were for example about 50,000 attendances at Beaumont Hospital annually for warfarin blood tests.
"You could get it done in your local post office probably but we insist on having 50,000 people in to get it done in a hospital because that's the way we always done it . . . we've got to change it," he said.
He added that capacity in hospitals could also be freed up by doing more day case work, by shortening lengths of stay, having diagnostic services open for longer so that patients did not occupy beds unnecessarily waiting for scans, and by treating more people with chronic disease in the community.
It was a huge challenge, he said, to decouple in the public mind the idea that good healthcare only came from getting into a hospital. "I'd actually suggest to you it's the opposite. If you end up in a hospital, inappropriately especially, you're going to be very very unhappy if you pick up a hospital acquired infection which is always going to be a risk," he said.
Much of the HSE transformation programme would focus on moving healthcare out into the community, rather than providing bigger hospitals with more beds, he said.
More primary care centres and more units for longterm care of the elderly were required.
Prof Drumm said his goal was to provide easy access to all services. He said patients in emergency situations such as those who have had heart attacks have no problem with access whether they are public or private.
"The problem really is access to what we would call elective work. If you've got a stiff hip, there's absolutely no doubt that your access to the system is very much determined by whether you can pay or not a lot of the time and certainly waiting lists become a problem," he said.
"We believe if access became easy that there would be a great increase in public confidence in the system," he added.
Prof Drumm was speaking at an all island infrastructure investment conference in Dublin.