CEO of the health insurer Vincent Sheridan told an audience at a private health conference in Dublin last Wednesday that they would become part of the process at the "appropriate time".

"The construction of new private hospitals to be colocated with public hospitals is a public policy decision, " he said.

"We will enter negotiations at the appropriate time with these new facilities and endeavour to negotiate competitive rates on behalf of our members, " he added.

However they will only get involved when the hospitals are ready to take patients.

The previous position of the VHI was that there were enough private beds operating in Ireland and the health insurer was seen as an obstacle to the development of private health care.

Health insurers pay more for beds in private hospitals then they would in public hospitals.

Commercial director of the Beacon Medical group Pauline Cullen says the banks took a great risk when they built their Sandyford facility as they did not have VHI support.

"It definitely made it more difficult to access the finance we needed. They have threequarters of the health insurance market and it was the biggest issue the banks had with the project, " she told the Sunday Tribune.

The policy of health insurance companies is still one of the biggest risk elements involved in the roll out of private hospitals according to leading health consultant Noel Daly, who is managing director of the Health Partnership.

"Their attitude will have a major bearing on what happens, " he said "There is a big onus on the private healthcare sector to deliver. It will put up costs significantly for them and they are a major player in this project. There are still huge risks involved, " he added.