A major reorganisation of services for people with cystic fibrosis has been recommended in a new report for the HSE.
The report says measures are also needed to bring staff and accommodation to international guidelines as well as to improve infection control and access to single rooms.
The Working Group Report on Services for People with Cystic Fibrosis says 1,094 patients with the condition are treated in CF units around the country.
However, it says optimum care cannot be met in all of the hospitals currently providing care.
It recommends three levels of care on a national, specialist and shared-care basis.
The two national centres would be in Dublin, with Our Lady's Children's Hospital in Crumlin catering for paediatric patients and St Vincent's University Hospital dealing with adults.
Specialist centres for north Dublin would be located at Beaumont Hospital and the Children's University Hospital Temple Street and for south Dublin at St Vincent's Hospital, Our Lady's Children's Hospital and Tallaght Hospital.
Child and adult specialist centres would also be located at Cork University Hospital, the Mid Western Regional Hospital Limerick and in Galway at University College Hospital and Merlin Park.
Shared care with a special centre would be provided at Waterford Regional Hospital and Our Lady of Lourdes Hospital in Drogheda.
The report says an extra €10m will be needed over three years to provide extra staffing.
To reduce infection control, home care should be provided for suitable patients, en-suite single rooms for inpatients and 24-hour access to a cystic fibrosis centre, with direct admission to a CF unit without having to be admitted through an emergency department.
The report says a national laboratory needs to be established to deal with speedy diagnosis of respiratory infections.
Routine newborn screening for the condition should also be established as soon as the services and infrastructure are in place.