Sometimes the obvious, rather than the conspiracy theory is closer to the bone.
Working in the HSE, I agree. I don't see any evidence of conspiracy but plenty of short-term thinking and clientelism.
For example, we have too many hospitals for a country with our population and geography but it is political poison for TDs.
Private healthcare is a safety valve for the HSE/DoH that lets the pressure off just enough so that they can muddle through - e.g. NTPF outsourcing.
There is also the historical mess of amalgamating all the Health Boards, never mind the Byzantine service arrangements with various voluntary hospitals and charities.
As for the system as it is - we took something like 3,000 beds out of the Public Hospitals in 1987.
Less than half of them have, I hear, been restored.
Population in 1987 c3.5m
Population in 2023 c5m.
You can't fit a Quart into a Pint bottle (or for younger readers) 2 litres into a litre bottle
Healthcare has changed radically since 2007, never mind since 1987. Some procedures that used to require a week in hospital are now day cases, so we don't need as many beds for those. We have also moved a lot of assessments and treatments to outpatient clinics and even to the home. For example, many sleep studies which once required an overnight hospital stay in a specialist unit can now be done by the patient themselves in their own bed.
So the demand for hospital beds should (in theory) be lower now than it was in the 80s. But what has also changed is the demographics - we now have people who are living longer with more complex conditions, and the care is not available for them in the community, whether it's in their own home, nursing home, etc. That puts back-pressure on hospitals, which in turn creates a demand for beds.
Another major issue with hospital "beds" is that we are not really talking about physical beds and rooms, moreso the ward clerks, porters, nurses, physios, etc. that are required to staff them. In many hospitals they are already unable to maintain full rotas so adding more beds would be impossible.