Fine Gael in government would introduce a new medical grade, a career hospital doctor, who would not be a consultant, to alleviate pressure on the health system.
According to its Plan for the Nation, the party would introduce a new system of career "hospital specialists" who would work full-time in the hospital. It would also separate "accident" care, which could be handled by experienced GPs and nurses, from the true "emergency" element needing the attention of senior specialists.
"These hospital specialists would be full-time in the hospital, they should be paid a salary that would be equal to or above the salary paid to consultants with supplementary private practices . . . In this way we could ensure that there would always be a senior medical decision-maker on site in the hospital to deal with any case that needed a senior-level decision."
Speeding up medical decision-making in hospitals would dramatically reduce waiting lists, the report says.
"Many of the patients currently on waiting lists could have routine operations carried out by these hospital specialists. For instance, those waiting for cataract, varicose vein and grommet operations could be operated on straight away by people who are not consultants."
It says that contracts given to hospital consultants and other professionals must be performance-sensitive, with a proper level of monitoring.
The plan provides for an expanded patients' charter, which would set specific time limits for a patient to see a consultant and to obtain treatment, the appointment of extra consultants, and an increase in public health nurses from 1,400 to 2,000.
It proposes a new approach to chronic illnesses such as diabetes and asthma, and an increase in income thresholds for medical cards which would bring an additional 450,000 people into the GMS.
It is proposed that thresholds would increase by over 100 per cent, to £10,200 for a single person, £16,820 for a married person and £19,720 for a married person with two children.
According to the document, waiting lists for surgical treatment in hospitals are up almost 20 per cent nationally and almost 50 per cent in Dublin over the past three years. This does not include the thousands "queuing to join a queue" to see a consultant.
Nearly 15,000 patients, including more than 3,000 children, are waiting for periods in excess of the Department of Health guidelines. "Hospital waiting lists are a politically-created phenomenon and can be removed by political actions."
Elderly patients would have to wait 18 months for a heart operation on the public waiting list, it says, but if they paid £12,000 to the consultant they could have the operation straight away as private patients.
Over 2,000 people with a disability are waiting for a residential place and 6,000 for day care, while 6,000 children with crooked teeth were waiting six years even to start a course of orthodontic treatment.
"Why does a wealthy nation provide such poor services to people when they are at their most vulnerable?" the report asks.