ONE of the architects of Tony Blair's health reforms in Britain has likened the Irish government's health policy to "rearranging deckchairs on the Titanic" and said its rigid focus on co-location failed to take account of patient needs.

"You need to look at what the patients need. If that means co-location in a particular place, fine. If that means a new public hospital, you build that. To sit down and structurally hamper yourself by saying it always has to be co-location is a bad thing to do," said former NHS commercial director general Ken Anderson.

Anderson, who is now managing director of UBS Investment Bank, also said that public-private partnerships (PPPs, known as PFIs in Britain) represented an inflexible means of building health infrastructure.

"If you build a road which is going to be fundamentally the same 20 years from now, it's a great idea. But healthcare changes over time. It has to be based on outputs, not inputs, but PFIs are an input-based system," he said.

Anderson did offer some comfort to those involved in co-location, stating there was still demand among investors for health projects despite the credit crunch.

"It's difficult to raise finance but from a recessional viewpoint, healthcare is one of the best, if not the best, investment strategy," he said. "There is money out there; you just have to look harder for it and it may be more expensive for operators. But at least they are in an industry which is recession-proof."

Anderson also suggested the government could take a leaf out of Blair's book and use the threat of the private sector to bring about change in public hospitals.

"Has all this co-location and chatting and rearranging of the deckchairs on the Titanic done anything for your health service? The politicians have to go to the doctor's unions and say, 'if you don't change, we're going to bring someone else in here who will do your job for you'," he said.