If everything goes to plan, Cullen will shortly give the keys to Triad Hospitals, a Fortune 500 company that will run the 180m medical centre once all the finishing touches are in place. American accents are already in evidence around Sandyford, as Triad staff run through the snag lists. Assuming the usual glitches can be sorted out smoothly, Beacon will open its doors at the end of October.

The occasion will give Irish people an altogether different hospital experience, with accommodation more akin to an upmarket hotel and cutting-edge design that not only looks good but should halt hospital super bugs in their tracks.

Beacon is the culmination of a dream shared by Cullen and two long-time friends, cardiac surgeon Mark Redmond and Paddy Shovlin, the property developer who Cullen beat into third place at the Ferrari Challenge. They believe the cure for Ireland's ailing health care system lies in applying some Americanstyle remedies.

The hospital's opening will also serve as a springboard for the three men's bigger ambitions to be part of the government's plans to tackle chronic hospital overcrowding by drafting in the private sector.

Beacon Medical Group, in which Cullen, Redmond and Shovlin are equal partners, is pinning its hopes on the colocation scheme championed by health minister Mary Harney. The group has been shortlisted to build six new facilities that are supposed to take the overflow of private patients from existing hospitals in Cork, Waterford and Limerick, as well as at Beaumont, St James's and Tallaght Hospitals in Dublin.

But co-location is far from a done deal and opposition political parties have pledged to dump the plan if they are successful at the next general election . . . not least because they claim it would perpetuate a two-tier health service.

Has Cullen backed a loser?

"The negative reaction to co-location has been political rather than based on common sense, " he says. "If this . . .

or any other government. . .

doesn't go ahead with it, what are the chances of public hospitals coming up with the facilities that are so desperately needed in our lifetimes, given that it takes about 18 years for public hospitals to proceed from initial concept to admitting their first patients?"

Only the private sector can come up with the quick fixes that are needed, Cullen says.

"If we're approved for the locations where we've been shortlisted, we'll have six new hospitals up and running within three years. We're geared up and ready to do it.

"In a Utopian world there would be ready access to health care with no waiting lists. But in the real world, co-location is absolutely the most effective approach. If a change of government causes it to fail, it would be a great pity."

Nevertheless, Beacon has already drawn up contingency plans. If co-location is scuppered, it will proceed with building new private hospitals on greenfield sites.

The critics of co-location also have issues with these one-off developments, dismissing them as tax-driven speculation rather than part of an integrated health care strategy.

Cullen rubbishes the notion that tax incentives provide so much easy money that speculators can throw up a new hospital wherever they see fit. "Anyone who saw the hoops we had to go through to get the financing [for Beacon] would know that a speculative hospital would never get built, " he says. "Tax equity on its own isn't enough to get a hospital project off the ground."

Nevertheless, there was no shortage of backers for Beacon and the scramble for a piece of the action meant that the fundraising arranged by Goodbody Stockbrokers was three-times oversubscribed.

In the end, 400 individuals ponied up an average of 100,000 each, while Ulster Bank and its parent, Royal Bank of Scotland, provided 115m in debt finance.

Tax-based investing is often frowned upon as yet another a privilege of the super-rich, but Cullen says Beacon attracted a wide spread of backers, with nobody putting in more than 1m and many investing the minimum 50,000.

Because the tax breaks can only be used to shelter rental income, Cullen says, they are artificially skewed. "The only people who can avail of them are the owners of land and buildings and they've already seen the value of their investments grow exponentially in recent years. The incentives should be opened up to a greater number of people by allowing the investment to be written off against total income."

The Beacon tax breaks will cost the Exchequer an estimated 70m over the next decade, according to Cullen's estimates. But he insists that the state will more than recoup this money through VAT, stamp duty and the income taxes paid by the 550 people that Beacon will employ at full capacity.

Apart from clearing the builders off the premises on time, Cullen's other big headache involves getting somebody to pick up the bills for all the patients that will shortly be passing through Beacon's imposing atrium.

This means striking a deal with the National Treatment Purchase Fund, which pays for people crowded out of the public health care system, and with the private health insurance companies. Until agreements are nailed down, Beacon's customers face the frightening prospect of paying for treatment from their own pockets.

The scale of the challenge can be seen from the plight of the Galway Clinic, which blamed recent financial cutbacks on a lack of business from the National Treatment Purchase Fund and an unfavorable contract with VHI, the dominant health insurer.

Does that not cause jitters in Sandyford?

Cullen says he is optimistic of cutting deals on mutually agreeable terms, hinting that a contract with start-up health insurer Vivas is imminent. He also seems to subscribe to the "build it and they will come" philosophy that motivated Kevin Costner's character in the film Field of Dreams.

"There will be pressure on all bodies to reach agreement with a well-located, wellequipped and properly-staffed facility like we have. It will be very difficult for anybody, be it VHI or the Treatment Purchase Fund, to turn around and refuse to cover us. We have to give them a competitive pricing model and they have to respect that we have a facility that has to be paid for."

With the countdown to launch well underway, a more cautious man might lose sleep at the lack of cover. But Cullen says issues such as insurance cover typically go down to the wire.

"If you didn't build a hospital until you knew VHI funding was in place, life would pass you by, " he says. "Of course there are risks, but life in the private sector is about taking risks."

It is easy to link the pressures of work and the birth of his first child to a slippage in Cullen's performance at the race track; on current performance, he is headed for second place in the 2006 Ferrari Challenge. But he prefers to see challenges as opportunities.

"Has it been a busy year?

Yes. But we've been on a tremendous learning curve.

The next project we undertake will be more efficient and successful than this one, and the one after that will be better again."

CV MICHAEL CULLEN
Age: 43
Job: Chief executive, Beacon Medical Group
Family: Wife and baby
Lives: Carrickmines, Co Dublin
Education: Commerce at UCD
Drives: Land Rover
Hobbies: Motor racing, squash, gym

BEACON HOSPITAL
Investment: 180m, including 43m of tax equity and 115m in debt finance
Beds: 183 when fully operational
Operating theatres: Eight Floor size: 238,000 sq ft over nine floors
Operator: Texas-based Triad Hospitals