Otago and Southland District Health Boards have been consulting about whether public patients should be able to pay for extra unfunded treatments in their public hospitals.
In an email response to questions raised by the Otago Daily Times on whether there should be clarification on this issue nationally, Mr Ryall said there were already a lot of private/public ventures in the health system, many of them reflecting local needs.
Among these were a private ward at Masterton Hospital where specialists rented the public operating theatres, private accident and medical centres at Wanganui Hospital and Wairau Hospital in Blenheim, and private operations which had been done in Ashburton and Whakatane Hospitals.
He also referred to the privatisation of Otago and Southland hospital laboratories.
"Interestingly, these examples happened under the previous government, which now says it is against such services."
The Government wanted a "one system" approach which put patients first.
That would mean some local flexibility, he said.
"We'll consider each situation based on local conditions."
Protocols, originally agreed by the Labour Cabinet in 2000, were amended in 2005 and again last year.
The section relating to a public hospital providing private treatment states that this is only likely to be acceptable to the minister if it meets seven conditions.
These include that there is no reduction in service or service quality for publicly funded patients; there must be spare capacity, as the level of publicly funded service must already meet or exceed guidelines set out by the minister; and there must be public disclosure of the arrangement.
Ninety submissions have been received by the boards on the "Bridging the Gap" consultation paper.
Chief executive Brian Rousseau told this month's Otago board meeting that the subject had received much national attention.
Two major concerns aired were whether it was the thin end of the wedge for increased private health care to relieve government funding and whether private patients would be able to jump the queue.
These were valid concerns which would need to be addressed in the report which is expected to come back to the board next month.
Board member Dr Branko Sijnja said for him it was an issue of preventing fragmentation of care.
It was a huge issue for people ill with cancer who wished to pay for private treatments to have to go elsewhere to get them.
Member Peter Barron said some arguments were forgetting the fact that there were " real people with real problems" involved.
