Major changes are essential in the Republic's creaking health service, its top chief admitted tonight.
Professor Brendan Drumm said an overhaul was no longer simply an option — but a necessity.
The Health Service Executive's chief executive officer made his remarks at the RTE Michael Littleton Memorial Lecture in Dublin.
"We haven't yet reached the stage where everyone involved in providing health and social services fully accepts that we are all, collectively, responsible for the success and future of the health services," he said.
"We all have to recognise that continuing to do things as they have been done in the past will lead to health and social care systems that are unable to cope, financially unsound and unable to provide quality care."
He insisted some progress was being made, adding that an average of 90 per cent of patients at accident and emergency wards are being admitted without "unnecessary" delay.
"Significant change is not an option — it is a necessity," he said.
The lecture, entitled Access, Confidence and Pride — The Key Foundations For A World Class Health Service, is to be broadcast on RTE Radio 1 on St Stephen's Day.