The Minister for Health believes there are many benefits in bringing the private sector on to public hospital premises, writes Martin Wall.
When the Tánaiste, Ms Harney, was appointed as Minister for Health six weeks ago, she said that her intention was not to reinvent the wheel but to accelerate change.
Her intention to encourage greater private sector involvement in the health sector is very much part of such a policy.
There has been private sector involvement in the public hospital sector for decades. Around 20 per cent of the country's public hospital bed stock is officially designated for fee-paying patients.
Public hospitals such as the Mater and St Vincent's in Dublin have had separate private facilities on nearby sites for many years.
And since the early 1990s, the State has used hospitals outside the public sector as a safety valve for tackling lengthy waiting lists.
The Progressive Democrats intensified this process through the establishment of the National Treatment Purchase Fund, which buys care in the private sector for those waiting longer than a year for treatment.
Now, the Tánaiste wants to encourage the private sector on to the campuses of public hospitals under new business agreements with health authorities.
The proposed developments, which could include additional beds, step-down care facilities or other treatment services, would be funded by the private sector - which would assume all risks. The State could buy services for the new private sector units, as required.
For its champions, such developments have a number of benefits.
First, health service management considers it better to have medical consultants carrying out their private practice on public hospital sites - where they are available in cases of emergencies - rather than in private clinics frequently several miles away.
And, if new private hospitals are to be developed largely as a result of tax breaks provided by the Government, the argument goes, then it would be better to have them on a public site where the local hospital could earn revenue through rent or lease arrangements. Furthermore, the introduction of private sector money could ease, to a degree, the almost insatiable demands of the public health services for Exchequer funding.
Sources close to the Tánaiste told The Irish Times last night that in their view the public sector did not have the capacity to fund all health service requirements.
As an example of how public/private co-operation in this area could help, sources pointed to the recent contract signed by the Eastern Regional Health Authority which will see the private Beacon Court Clinic in south Dublin providing dialysis service to public patients until a new centre is built in Beaumont Hospital.
While the Tánaiste's initiative is perhaps unexpected, the new position of the Department of Health on the Hanly report marks an acknowledgement of the level of opposition which the planned hospital reforms face around the country.
The Hanly report, which involved major investment in regional hospitals and a scaling back of services in smaller centres, became a stick with which to beat the Government during the local elections. The public feared that after the cuts were made, the promised new services would never materialise.
Now sources close to the Tánaiste believe that the public will have to see additional consultants and enhanced ambulance services actually in place on the ground before they will accept any new hospital configuration.
But the Government is unlikely to approve the appointment of the additional 1,000 consultants required before a new contract for senior doctors is agreed.