Bertie Ahern (Dublin Central, Fianna Fail)

I think the Deputy is confused on the issue. The policy of co-location was enunciated in July 2005. There is no confusion about the policy. The question I was asked on 28 February was about the contracts. I am not involved in the detail of the contracts. I do not involve myself with any of the agencies about the stage of contract and negotiation they are in. I have no knowledge today, nor had I then, of the stage the contracts are at. The contracts are being dealt with by the negotiators in the HSE and I do not know whether they will be finished this week, next week or in six months' time. They have told me they will issue an invitation to tender to selected bidders at the end of this week or early next week. That will be in March. Where they go from there will be a matter for their negotiations but the Minister for Health and Children said today she expected some of those would be finished at the end of April. The overall issue on co-location is to achieve one central purpose, namely, to improve the services for all patients, particularly public patients at public hospital campuses.

For many years, which I do not think people quite understand, we have had 2,500 private beds in public hospitals ring-fenced for privately insured patients. In addition many public beds have been used for private patients. We have excessive use of the public hospital beds for private fee earning by consultants. That has been the system for decades. This system has reached its limits and it simply must change. Since we enunciated the policy in summer 2005 we have said we want all the beds in public hospitals to treat all patients and we have moved on the first 1,000 of those. We will free up many of these beds by inviting the private sector to invest in new hospital facilities in a planned way and a way that integrates services in public hospital sites and protects the public interest. We believe this is an innovative way. We are not saying it is the first place in the world to do it because many others have done it.

We believe it is a good solution under a number of headings. In value for money, it will achieve new public beds at less than half the cost of direct construction of equivalent beds. That seems like a good idea to us. As we know from our own experience it takes years on end to try to get a public hospital from the time it starts to the time it is constructed, commissioned and staffed. By doing this we could get 1,000 public beds in operation far more quickly. The best commercial terms will be paid to the State for leasing the land. Nothing will be given away.

The second position is the speed of building. The private sector has a track record of building quickly. I have been criticised several times on Leaders' Questions as to why we can build in the private sector but cannot do it in the public sector. It is true. We have all the procurement and other arrangements, but we cannot do it as fast. That is a second good reason.

The third reason is that it is a new source of investment in health. The new private-sector investment will complement our public health capital programme, which is already the highest in the world as a proportion of national income. With billions of euro being invested in international property every year there is nothing wrong with channelling private investment into health. The next reason is that it gives equity for all patients. All admissions to a public hospital will be on the basis of medical need and all beds will be routinely available for public patients. As well as availability of new services the public sector will be able to purchase services from private providers at discounted prices. We believe all of those are good ideas, which will dramatically assist the public patient. That is the reason we are pressing ahead with this.

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